also

known Rubella as or three-day measles, The name "rubella" is derived from Latin, meaning little red. Rubella is also known as German measles because the disease was first described by German physicians in the mid-eighteenth century.

n temperate areas, the peak incidence of infection occurs during late winter and spring. Infection is transmitted via respiratory droplets, which can remain active and contagious, either airborne or on surfaces, for up to 2 hours. Initial infection and viral replication occur locally in tracheal and bronchial epithelial cells. After 2-4 days, measles virus infects local lymphatic tissues, perhaps carried by pulmonary macrophages. Following the amplification of measles virus in regional lymph nodes, a predominantly cell-associated viremia disseminates the virus to various organs prior to the appearance of rash. Measles virus infection causes a generalized immunosuppression marked by decreases in delayed-type hypersensitivity, interleukin (IL)-12 production, and antigen-specific lymphoproliferative responses that persist for weeks to months after the acute infection. Immunosuppression may predispose individuals to secondary opportunistic infections,[5] particularly bronchopneumonia, a major cause of measlesrelated mortality among younger children. In individuals with deficiencies in cellular immunity, measles virus causes a progressive and often fatal giant cell pneumonia. In immunocompetent individuals, wild-type measles virus infection induces an effective immune response, which clears the virus and results in lifelong immunity.[6]

Pathophysiology Rubella is transmitted from human to human only by direct or droplet contact with infected body fluids, most commonly nasopharyngeal secretions. [4] Patients may shed infectious virus from 7 to 30 days after infection (from 1 week before to 2 weeks after the onset of rash). However, infants with congenital rubella syndrome may be contagious for >1 year. The average incubation period is 14 days (range: 2 to 23 days), during which time the virus replicates in the nasopharynx and local lymph nodes and then spreads haematogenously throughout the body (including, in pregnant women, to the placenta and fetus). Systemic symptoms are due to viral infection, but some manifestations (rash, thrombocytopenia, arthritis) probably have an immunological basis.

This disease is often mild and attacks often pass unnoticed. The disease can last one to three days. Children recover more quickly than adults.

Infection of the mother by Rubella virus during pregnancy can be serious; if the mother is infected within the first 20 weeks of pregnancy, the child may be born with congenital rubella syndrome(CRS), which entails a range of serious incurable illnesses. Spontaneous abortion occurs in up to 20% of cases.

Rubella is a common childhood infection usually with minimal systemic upset although transient Arthropathy may occur in adults. Serious complications are very rare.

 Mild

but highly contagious disease characterized by:

Fever Exanthem Macular rash

Infection

during 1st trimester of pregnancy may lead to congenital anomalies:

Congenital Rubella Syndrome

Rubella virus found in nasopharyngeal discharges, in blood and later in stools and urine

 Direct

contact/ indirect contact Respiratory droplet Mother to baby

Teratogenic properties

 14-21

days

week before and 4 days after the appearance of rashes

 Pre

- eruptive stage

Lower grade fever Mild Catharral symptoms mild conjunctivitis Forcheimers spot small red lesion in the soft palate pathognomonic sign

 Eruptive

Stage

Pinkish maculopapular rash begins on the 1st day and begins in the face and spreads Rashes fade 2-3 days and leave ni pigmentation or desquamation Enlargement of lymph nodes Pain and swelling of the joints

 Encephalitis Congenital

rubella syndrome

Spontaneous rubella syndrome Intrauterine growth retardation Cleft lip, Cleft palate, Clubfoot Heart defects Eye defects, ear defect Mental Retardation

Same as measles Treatment for rubella focuses on caring for the specific symptoms, such as getting plenty of rest and drinking extra fluids so you do not get dehydrated. Acetaminophen, such as Tylenol, can be given to children and adults for fever. Do not give aspirin to anyone younger than 20 because of the possible link between aspirin and Reye syndrome. Women considering pregnancy who are unsure of their immunity to rubella may be vaccinated safely up to 1 month before becoming pregnant.

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end!