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VIROLOGICAL ASPECT OF RUBELLA
History
Transmission is by respiratory
Replication in nasopharynx and regional
lymph nodes
Viremia 5-7 days after exposure
with spread to tissues
Placenta and fetus infected during viremia
Incubation period is 2 to 3 weeks
The lytic & lysogenic Cycle
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CLINICAL MANIFESTATIONS
Malaise
Headache
Myalgias and arthralgias
Post-auricular adenopathy
Conjunctivitis
non-pruritic, erythematous,
maculopapular rash
LABORATORY TEST
Pregnant women
Patients receiving immunoglobulin
Patients who are seriously ill
Patients with severe altered immunity
Patients on immunosuppressive therapy
Patients with HIV
ADVERSE REACTIONS TO VACCINATION
Fever 5%-15%
Rash 5%
Joint symptoms 25%
Thrombocytopenia <1/30,000 doses
Parotitis rare
Deafness rare
Encephalopathy <1/1,000,000 doses
COMPLICATION
Congenital Rubella Syndrome (CRS) is the
most severe and important complication
the severity depends on how early the
infection occurs.
%50
45
40
35
30
25
20
15
10
5
0
1-4 wks 5-8 wks 9-12 wks > 12 wks
MANIFESTATIONS OF CONGENITAL
RUBELLA
%80
70
60
50
40
30
20
10
0
Deafness Eye CNS Cardiac
*The Lytic Cycle
*The Lysogenic Cycle