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.

Introduction

  • Rubella, also known as German measles or 3-day measles, is a mild & self-limiting disease associated w/ a characteristic rash
  • Before vaccination era, the peak incidence is in 5-14 yrs of age
    • Currently, it involves the adolescents or young adults

 Congenital Rubella Syndrome (CRS)

  • Neonatal manifestations of rubella during maternal infection
  •  Severity of effects on the fetus varies according to the gestational age at which the maternal infection occurs
    • The most severe & widespread defects occur during maternal infection in the 1st trimester of gestation

Etiology

  • A single-stranded RNA virus classified as a togavirus, genus Rubivirus
  • Transmission is through airborne or droplets shed from respiratory secretions
  • Highly communicable on 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
  • Incubation period is 14-21 days

Signs and Symptoms

  • Prodromal symptoms of low-grade fever, conjunctivitis, sore throat, coryza, headaches, malaise & lymphadenopathy usually last for 1-5 days before the onset of rash
    • The prominent lymph nodes are the suboccipital, postauricular & anterior cervical nodes
  • Rash is maculopapular & appears 14-17 days after exposure
    • Rash begins on the face & forehead as small, irregular pink macules that coalesce
    • It spreads centrifugally to the trunk & extremities as discrete macules
    • It then resolves w/in 3 days in the same order it appeared, usually without desquamation
    • May be more prominent after taking a bath or a hot shower
    • The rash may be pruritic
  • Forschheimer spots on the soft palate may be noted about the time of rash onset, but are not diagnostic
  • May be asymptomatic in 25% to 50% of patients
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