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GERMAN MEASLES
HISTORY - RUBELLA
7
AGENT FACTORS cont.
B- Source of C- Period of
infection communicability
CASES It probably extends from a
Subclinical week before symptoms to
about a week after rash
Clinical
appears.
Congenital from infected
Infectivity is greatest
pregnant women to
when the rash is erupting.
fetus.
There is no known
carrier state.
HOST FACTORS
A- Age B- Immunity
Disease of childhood 3-10 yrs One attack results in life long
age group. immunity.
Following widespread Infants of immune mothers
immunization campaigns are protected for 4-6 months.
persons older than 15 yrs In India, about 40% of child
account for 70% cases in bearing age group women
developed countries. are susceptible to rubella.
Immunity - Rubella
Antibodies appear in serum
as rash fades and antibody
titers raise
Rapid raise in 1 – 3 weeks
Rash in association with
detection of IgM indicates
recent infection.
IgG antibodies persist for life
ENVIRONMENTAL FACTORS
• Cough • Mild
• Minor • Rashes arthralgia
sore • Lesions • arthritis • Placentitis
throat • Fetal
• Lymphadenopathy Damage
Transmitted Infects cells in
via respiratory the upper
Rubella virus droplets respiratory
tract
Virus
Virus replicates in Extends in the multiplies
the nasopharynx regional
lymph nodes
Fleeting enanthema
Pinpoint or larger
petechiae that usually
occur on the soft palate
in 20% of patients
Similar spots can be
seen in measles and
scarlet fever.
Systemic events of Rubella Infection
28
Main Clinical Events During Pregnancy
Cataract
Cardiac abnormalities
Deafness
Salt and pepper retinopathy
Post natal Rubella
Occurs in Neonates and
Childhood
Adult infection occurs through
mucosa of the upper
respiratory tract spread to
cervical lymph nodes
Viremia develops after 7 – 9
day
Lasts for 13 – 15 days
Leads to development of
antibodies
The appearance of antibodies
coincides the appearance of
suggestive immulogic basis for
the rash
In 20 – 50 % cases of primary
infections are subclinical.
Diagnosis of Rubella in Adults
ClinicalDiagnosis is unreliable
Many viral infections mimic Rubella