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.

Prevention

Rubella vaccine is available as a single-antigen preparation or combined w/ other vaccines [eg mumps & rubella (MMR), or also w/ varicella (MMRV)]

  • MMRV is approved for use in healthy children ≥1-12 yrs of age
  • Routine vaccination against rubella is recommended for all children ≥12 mth; second dose should be routinely given at 4-6 yrs of age
  • Children ≤12 yr w/o previous immunization should be given at least 1 dose of MMR or MMRV
  • May be effective, theoretically, as post-exposure prophylaxis if given w/in 3 days of exposure
  • Single antigen is not routinely recommended

Prevention for Exposed Pregnant Women

  • Counseling regarding the risks & benefits of termination of pregnancy should be off ered to susceptible pregnant women exposed to rubella

Post-exposure Prophylaxis

  • Immunoglobulin may be given if termination of pregnancy is not an option based on maternal predilection
    • May reduce the risk of clinical infection but may not give an assurance of prevention of fetal infection
    • Dose of 0.55 mL/kg IM may be given
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