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