RUBELLA

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RUBELLA
Single-stranded, enveloper RNA virus of the genus Rubivirus
Family Togaviridae
Disease caused: German measles
Benign, self-limiting
Infects children, young unvaccinated adults
Incubation period: 12-23 days
Mode of Transmission
Direct contact with respiratory droplets
Transplacental
Viral Replication Site:
Upper Respiratory Tract
Cervical lymph nodes
Sign & Symptoms:
Erythematous maculopapular rash
Initially appears on the face
Spreads to the trunk and extermities
Disappear in 3-5 days
Adolescents and Adults:
Asymptomatic
Low grade fever, malaise, swollen gland, Upper Respiratory Infection for 1-5 days
Other Clinical Manifestation:
Encephalitis, thrombocytopenia with hemorrhage, neuritis
Infection during pregnancy:
May lead to:
Miscarriage, stillbirth
Congenital rubella syndrome (CRS)
Deafness, eye defects (cataracts, glaucoma)
Cardiac abnormalities
Mental retardation, motor disabilities
Congenital Malformations/Deformities
Rubella Vaccine
Live, attenuated rubella virus
Mandatory immunization in infants and children
Given in combination with other vaccines for measles, mumps and varicella:
MMR Vaccine “measles/mumps/rubella vaccine”
MMRV Vaccine “measles/mumps/rubella/varicella
Laboratory Diagnosis
Viral Culture: slow growth
Serologic Tests: preferred method of diagnosis
Hemagglutination Inhibition (HI)
Passive Hemagglutination
Complement Fixation
Latex Agglutination
Immunoassays
Chemiluminiscence
ELISA: most commonly used:
Solid phase Capture ELISA: detects IgM Rubella antibodies
IgM and IgG rubella antibodies elevate as the rashes (of German measles) begin to disappear
IgM declines in 4-5 weeks (but may persist in low levels for a year)
IgG rubella antibodies: marker of lifelong immunity
Vaccination
Natural exposure
Lab Diagnosis for Congenital Rubella Infection
Test mother’s serumfor the presence of rubella antibodies
Test fetal blood, cord blood, neonatal serum: rubella-specific IgM
Positive Igm

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