Rubella is an acute febrile illness caused by Rubella virus, a single-stranded RNA virus of Togavirus family
-It is commonly known as German measles or 3-day measles.
-the virus enters the body through inhalation
-it replicates in the upper respiratory tract and spreads in the bloodstream to other organs, skin and lymphoid tissues
-the incubation period is 14 to 21 days
-the virus has high infectivity but low virulence
Symptoms & Signs
A.Infection in young children and adults: Fever, rash, malaise, arthralgia, lymphadenopathy, which is most prominent in the posterior cervical and postauricular areas.
Arthralgia: The most common complication of Rubella is arthralgia, and it occurs most frequently in women
Rubella rash: A fine, pink maculopapular rash begins on the face and rapidly spreads to the trunk and extremities. It lasts for 3 days.
-The greatest significance of rubella is not the acute illness but the risk of fetal damage in pregnant women.
-the risk of fetal malformation is highest in the early stages of pregnancy
-Intravenous immune globulin injected into the mother does not protect the fetus against rubella infection
-The classic triad of congenital rubella consists of cataracts, cardiac abnormalities, and deafness.
-The most common developmental manifestation of congenital rubella is mental retardation.
A.General: Failure to thrive, growth retardation, malabsorption
B.Cerebral: Microcephaly, encephalitis
C.Ocular: Cataracts, glaucoma, microphthalmia, chorioretinitis
D.Deafness: Sensorineural in most cases
E.Cardiac: Pulmonary artery stenosis, pulmonary valvular stenosis,
patent ductus arteriosus, ventricular septal defect
F.Hematologic: Thrombocytopenia, lymphopenia, intravascular coagulation
G.Skin: Blueberry muffin purpura on head, neck and trunk
Confirmation of the diagnosis requires laboratory studies.
A. Nucleic Acid Detection: Rubella virus nucleic acid is detected using RT-PCR
B. Isolation and Identification of Virus: Rubella virus isolated from nasopharyngeal or throat swabs
C. Serology: Rubella HI test
Infection in young children and adults: Rubella is a mild, self-limited illness; no specific treatment is indicated; Patients should be isolated for 7 days after rash onset
Congenital infection: there is no specific treatment
The primary purpose of rubella vaccination is to prevent congenital rubella infections.
-Live attenuated rubella vaccine (MMR or MMRV) given in two doses, first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age
-Pregnancy should be avoided for at least 28 days after vaccination.
-Pregnant women should not receive the vaccine, but should be screened for rubella IgG antibodies