rubella
RUBELLA
Rubella, also known as German measles or 3-day measles, is a mild often exanthematous disease of infants and children that is severe and associated with complications in adults. It is self-limiting disease associated with a characteristic maculopapular rash.
It is caused by a single-stranded RNA virus classified as a togavirus, genus Rubivirus.
Transmission is through airborne or droplets shed from respiratory secretions.
Highly communicable at the onset of the rash, however viral shedding may also occur 5-7 days before, to 5-7 days or more following appearance of the rash.
The incubation period is 14-21 days.

Diagnosis

  • Diagnosis is based on clinical findings

Physical Examination

Congenital Rubella Syndrome

  • May have several manifestations including the following:
    • Deafness - most common finding
    • Eye defects (eg cataracts, glaucoma, salt-&-pepper retinopathy)
    • Cardiac abnormalities (eg patent ductus arteriosus, pulmonic stenosis)
    • Neurologic defects (eg microcephaly, mental retardation)
  • Manifestations may be delayed from 2-4 yr & may include DM, glaucoma, thyroid dysfunction

Laboratory Tests

Lab Exam

  • Serologic test is the most common method of confirming rubella infection, however it is seldom needed except in pregnant women where it is imperative
    • There is a fourfold rise in rubella IgG antibody titer in acute- & convalescent-phase serum specimens
    • Presence of rubella specific IgM antibody
    • In newborns, increased levels of IgM antibodies indicate a recent infection acquired after birth
    • Ideal time for serum collection is w/in 7-10 days after the onset of illness & 14-21 days later
    • Enzyme-linked immunosorbent assay (ELISA) is often used to test for rubella antibodies
  • Positive viral culture may confirm rubella infection
    • Virus may be isolated from blood, throat, nasal, urine & cerebrospinal fluid specimens of rubella & CRS patients
    • Rubella virus may be isolated during the acute phase, 1 wk before to 2 wks after the onset of rash
    • Not generally used for routine diagnosis

Complications

  • Uncommon in patients & generally not life-threatening
  • May include postinfectious thrombocytopenia, orchitis, Guillain-Barré syndrome & peripheral neuritis
  • Encephalitis is the most serious complication, occurs in 2 forms
    • Postinfectious encephalitis appears w/in 7 days after the onset of rash
    • May present w/ seizures, confusion, ataxia & focal neurologic signs
    • Most patients recover completely
  • Progressive rubella panencephalitis has an onset & course similar to subacute sclerosing panencephalitis, a complication of measles
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
Roshini Claire Anthony, 3 days ago

The presence of pulmonary arterial hypertension (PAH) in individuals with systemic sclerosis is associated with an increased mortality risk, a study from Singapore showed.

23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Stephen Padilla, 6 days ago
Brodalumab has exhibited long-term efficacy and consistent safety profile for more than 2 years in the treatment of patients with psoriasis, results of the phase III AMAGINE-2 trial show.