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, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
Yesterday
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.
Tristan Manalac, 2 days ago
In patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PPCI), admission Killip classification and creatinine and troponin levels are important cardiac mortality predictors, according to a recent Singapore study.