Rubella Flashcards
What is a “exanthem”?
An “exanthem” is an eruptive widespread rash.
What are the 6 viral exanthemas?
Originally there were six “viral exanthemas” known as first, second, third, fourth, fifth and sixth disease. These have since been renamed as we have learned more about their underlying causes:
- First disease: measles
- Second disease: scarlet Fever
- Third disease: rubella (German measles)
- Fourth disease: Dukes’ Disease
- Fifth disease: parvovirus B19
- Sixth disease: roseola Infantum
What causes measles?
Measles is caused by the measles virus.
How is measles spread?
It is highly contagious via respiratory droplets.
How does measles present?
Symptoms start 10 – 12 days after exposure, with fever, coryzal symptoms and conjunctivitis.
Koplik spots are greyish white spots on the buccal mucosa. They appear 2 days after the fever. They are pathognomonic for measles, meaning if a patient has Koplik spots, you can diagnose measles.
The rash starts on the face, classically behind the ears, 3 – 5 days after the fever. It then spreads to the rest of the body. The rash is an erythematous, macular rash with flat lesio
Briefly describe the management of measles
Measles is self resolving after 7-10 days of symptoms.
How long should children remain off school for with measles?
Children should be isolated until 4 days after their symptoms resolve.
Is measles a notifiable disease?
Measles is a notifiable disease and all cases need to be reported to public health.
What % of patients with measles develop complications?
30% of patients with measles develop a complication.
What are the complications of measles?
Complications include:
- Pneumonia
- Diarrhoea
- Dehydration
- Encephalitis
- Meningitis
- Hearing loss
- Vision loss
- Death
What causes Scarlet fever?
Scarlet fever is associated with group A streptococcus infection, usually tonsillitis. It is not caused by a virus.
Scarlet fever is caused by an exotoxin produced by the streptococcus pyogenes (group A strep) bacteria.
How does Scarlet fever present?
It is characterised by a red-pink, blotchy, macular rash with rough “sandpaper” skin that starts on the trunk and spreads outwards. Patients can have red, flushed cheeks.
Other features:
- Fever
- Lethargy
- Flushed face
- Sore throat
- Strawberry tongue
- Cervical lymphadenopathy
Briefly describe the management of Scarlet fever
Treatment is with antibiotics for the underlying streptococcal bacterial infection. This is with phenoxymethylpenicillin (penicillin V) for 10 days.
Is Scarlet fever a notifiable disease?
Scarlet fever is a notifiable disease and all cases need to be reported to public health.
How long should children with Scarlet fever remain off school?
Children should be kept off school until 24 hours after starting antibiotics.
What other conditions is associated with group A strep infection?
Patients can have other conditions associated with group A strep infection:
- Post-streptococcal glomerulonephritis
- Acute rheumatic fever
What causes rubella?
Rubella is caused by the rubella virus.
How is rubella spread?
It is highly contagious and spread by respiratory droplets.
How does rubella present?
Symptoms start 2 weeks after exposure.
It presents with a milder erythematous macular rash compared with measles. The rash starts on the face and spreads to the rest of the body. The rash classically lasts 3 days. It can be associated with a mild fever, joint pain and a sore throat. Patients often have enlarged lymph nodes (lymphadenopathy) behind the ears and at the back of the neck.
Briefly describe the management of rubella
Management is supportive and the condition is self limiting.
Is rubella a notifiable disease?
Rubella is a notifiable disease and all cases need to be reported to public health.
How long should children remain off school for with rubella?
Children should stay off school for at least 5 days after the rash appears.
Which group of people do children with rubella need to avoid?
Children should avoid pregnant women.
What are the complications of rubella?
Complications are rare but include thrombocytopenia and encephalitis.
What is the significance of rubella infection in pregnancy?
Rubella is dangerous in pregnancy and can lead to congenital rubella syndrome, which is a triad of deafness, blindness and congenital heart disease.
