Rubella

German Measles
(first diagnosed by German
doctors)
Three day Measles

Rubella: Structure

enveloped
icosahedral
ss RNA sense
40-80 nm
30 nm core
hemaglutinin peplomers

+
ssRNA

Rubella: Classification

Family Togaviridae
genus Rubivirus only member
single serotype
three structural polypeptides
Unlike other
Togaviruses rubella
is not arthropod
borne

Rubella: Multiplication
RNA is capped and polyadenylated
serves as mRNA -> nonstructural
proteins
sense RNA -> antisense RNA
Antisense RNA template for progeny
RNA
antisense RNA--> mRNA ->
structural proteins
mature at intracytoplasmic
membranes

Rubella: Clinical
manifestations
Postnatal
rash
lymphadenopathy
low grade fever

Congenital
stillbirth
spontaneous abortion
birth defects

Congential Rubella
Ocular- cataracts, retinitis, glucoma
,microphthalmaia
Heart defects- patent ductus arteriosis
Deafness- cochelar deafness, central
auditory imperception
CNS- mental retardation, encephalitis,
microcephaly
Other- hepatitis, pneumonitis
IgM test

Rubella: Pathogenesis
respiratory secretions -direct
contact, droplet
multiplies in cells of respiratory
system
extends to lymph nodes, spleen

Rubella: Epidemiology

worldwide
vaccines licenced 1969
no new epidemics
incidence ~ 100 /year

Congential rubella
occurs in unvaccinated
susceptible young
women

Rubella: Host defenses

interferon
cell mediate immunity
neutralizing antibodies
hemagglutinin inhibiting antibodies

asymptomatic reinfection
possible

Rubella: Diagnosis
Clinical manifestations- rash,
lymphadenopathy
Isolate virus respiratory tract
Detect Rubella IgM

Diagnosis: Congenital
Rubella
isolate virus - urine, CSF, blood
maternal circulating IgG- lasts 6
months
Detect fetal or neonate IgM

Rubella: Control
live attentuated rubella vaccine
mumps-measles-rubella combination /
MMR

subcutaneous
15 months of age
asymptomatic in children
mild symptoms in adults

Rubella: Control Strategies

10-20% young women not
immunized
Therefore immunize
college students
health care personnel
military personnel
after childbirth, miscarriage or
abortion
USA data