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Rubella infection

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Rubella, also known as German measles, is caused by the rubella virus. It is highly contagious and transmitted through respiratory secretions. While it usually only causes a mild rash and fever, infection during pregnancy can lead to fetal abnormalities or miscarriage. Diagnosis involves testing for rubella-specific IgM and IgG antibodies through methods like hemagglutination inhibition, enzyme immunoassay, or latex agglutination. Public health efforts focus on vaccinating susceptible groups like children, women of childbearing age, and healthcare workers to prevent congenital rubella syndrome.

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Rubella Infection Group 3
Rubella Virus From Latin meaning little red Acquired rubella; German measles; 3-day measles Caused by an enveloped, single stranded RNA virus of the Togaviridae family Highly contagious and transmitted through respiratory secretions Occurred most often in childhood
Rubella Pathogenesis Respiratory transmission of virus Replication in nasopharynx and regional lymph nodes Viremia 5-7 days after exposure with spread to tissues Placenta and fetus infected during viremia
Individuals requiring rubella immune status determination: Preschool-age and school-age children All females at or just before childbearing age Women about to be married Married woman Pregnant woman Health care personnel
Clinical Features Incubation period 14 days (range 12-23 days) Prodrome of low grade fever Lymphadenopathy in second week Maculopapular rash 14-17 days after exposure
Koplik spots are seen with measles. They are small, white spots (often on an reddened background) that occur on the inside of the cheeks early in the course of measles may appear as irregular red spots with a minute, bluish white center opposite molars 2 days before rash
Congenital Rubella Syndrome Infection may affect all organs May lead to fetal death or premature delivery Severity of damage to fetus depends on gestational age Up to 85% of infants affected if infected during first trimester
Fetal abnormalities associated with maternal rubella infection: Encephalitis; Hepatomegaly; Bone defects; Mental retardation; Cataracts ; Thrombocytopenic purpura; Cardiovascular defects; Splenomegaly; Microcephaly
Immunologic Manifestations:
Diagnostic evaluation 1. Hemagglutination Inhibition (HAI) Most frequently used method of screening for the presence of rubella; reference method Disadvantage: it can detect a combination of IgM and IgG antibodies but it does not distinguish between them 2. Enzyme immunoassay for Antibodies The rubella-specific IgM often persists for 20 to 30 days after acute infection or vaccination and also in infants with congenital rubella
3. Latex agglutination Provide more rapid and convenient alternatives for HAI Positive result: visible clumps Negative result: latex particles are remain smooth and evenly dispersed Single specimen are required for qualitative determination of antibody levels Two specimens for quantitative testing
The first specimen should be collected within 3 days of the onset of rash or at the time of exposure and tested on arrival in the laboratory 2nd specimen is collected 7 to 21 days after the onset of tha rash or at least 30 days after exposure if no clinical symptoms occur. 2 ml of blood collected in red top evacuated tube Specimens maybe stored up to 48 hours at 2-8 degree C Sodium azide preservative present in latex reagent, buffer and control
4. Flourescent immunoassay Qualitative test card Used to detect the presence of rubella antibody

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Rubella infection

  • 2. Rubella Virus From Latin meaning little red Acquired rubella; German measles; 3-day measles Caused by an enveloped, single stranded RNA virus of the Togaviridae family Highly contagious and transmitted through respiratory secretions Occurred most often in childhood
  • 3. Rubella Pathogenesis Respiratory transmission of virus Replication in nasopharynx and regional lymph nodes Viremia 5-7 days after exposure with spread to tissues Placenta and fetus infected during viremia
  • 4. Individuals requiring rubella immune status determination: Preschool-age and school-age children All females at or just before childbearing age Women about to be married Married woman Pregnant woman Health care personnel
  • 5. Clinical Features Incubation period 14 days (range 12-23 days) Prodrome of low grade fever Lymphadenopathy in second week Maculopapular rash 14-17 days after exposure
  • 6. Koplik spots are seen with measles. They are small, white spots (often on an reddened background) that occur on the inside of the cheeks early in the course of measles may appear as irregular red spots with a minute, bluish white center opposite molars 2 days before rash
  • 7. Congenital Rubella Syndrome Infection may affect all organs May lead to fetal death or premature delivery Severity of damage to fetus depends on gestational age Up to 85% of infants affected if infected during first trimester
  • 8. Fetal abnormalities associated with maternal rubella infection: Encephalitis; Hepatomegaly; Bone defects; Mental retardation; Cataracts ; Thrombocytopenic purpura; Cardiovascular defects; Splenomegaly; Microcephaly
  • 10. Diagnostic evaluation 1. Hemagglutination Inhibition (HAI) Most frequently used method of screening for the presence of rubella; reference method Disadvantage: it can detect a combination of IgM and IgG antibodies but it does not distinguish between them 2. Enzyme immunoassay for Antibodies The rubella-specific IgM often persists for 20 to 30 days after acute infection or vaccination and also in infants with congenital rubella
  • 11. 3. Latex agglutination Provide more rapid and convenient alternatives for HAI Positive result: visible clumps Negative result: latex particles are remain smooth and evenly dispersed Single specimen are required for qualitative determination of antibody levels Two specimens for quantitative testing
  • 12. The first specimen should be collected within 3 days of the onset of rash or at the time of exposure and tested on arrival in the laboratory 2nd specimen is collected 7 to 21 days after the onset of tha rash or at least 30 days after exposure if no clinical symptoms occur. 2 ml of blood collected in red top evacuated tube Specimens maybe stored up to 48 hours at 2-8 degree C Sodium azide preservative present in latex reagent, buffer and control
  • 13. 4. Flourescent immunoassay Qualitative test card Used to detect the presence of rubella antibody