RUBELLA Flashcards
What kind of pathogen is Rubella?
Virus
How is Rubella spread? What is its incubation time?
-Droplets
Incubation time of 14-21 days after exposure
Symptoms will appear 1-5 dyas before rash occurs
Is Rubella teratogenic?
YES,
Teratogenic effects will occur especially in early weeks of gestation
Can cause congenital defects, abortions, still birth
*May cause Congenital Rubella in infants that survive
What is the pathogenesis of Rubella?
-Virus invades the respiratory epithelium of the nasopharynx
-From here will spread to the blood and goes everywhere
-Will spread systemically throughout reiculoendothelial system (liver, spleen, lungs)
-Second viremia will occur 6-20 days after infection, virus can be recovered from different body sites: lymph, urine, CSF, conjunctival sac, breast milk, synovial fluid in joints, lungs
-Viremia will appear just before the rash onset and disappears shortly after
How do rubella infections present?
In young children: mild symptoms, rash, suboccipital swelling
Older children/adults: arthralgia (joint pain), arthritis, thrombocytopenic purpura (low platelet count)
-eye pain in lateral or upward movement, conjunctivitis, sore throat, headache, general body aches, low-grade fever, chills, nausea, anorexia
-exanthem: ROSE-PINK PINPOINT maculopapular rash 1-4mm, in adults may be pruritic
-mouth lesions
How can Rubella be diagnosed?
-Serologic (blood) diagnosis
-rubella specific IgM antibody in single sample
-rubella specific IgG seen in titer 2-3 weeks apart
*false positives can occur from other infections
What is the treatment for Rubella?
-Supportive care
-TORCH panel for pregnant women (group of blood tests to test for other diseases that may be present)
What is Congenital Rubella?
Rubella illness in infants from maternal virus contraction during pregnancy
What is the epidemiology of Congenital Rubella?
-58% of affected patients may not be obvious until second year of life
-40% pf patients with Congenital Rubella syndrome may have deafness as the only abnormality
What is the pathophysiology of Congenital Rubella?
Transferred from mother to fetus through placenta
How can an infection with Congenital Rubella present?
-Sensorineural hearing loss is most common
-Ocular abnormalities (cataract, glaucoma, pigmentary retinopathy: salt and pepper pigmentation)
-Congenital heart disease in 50% of infants infected within the first 1-2 months of gestation
-CNS: May cause mental delay, behavioral disorders, meningoencephalitis, microencephaly
-Liver and spleen enlargement
-cutaneous BLUEBERRY MUFFIN SPOTS
How can Congenital Rubella be diagnosed?
-Will be suspected in infants under 30 months if rubella specific igG antibody levels are positive and do not decline at a normal rate (like they would if it was transfer of maternal antibodies for protection)
What is the treatment for Congenital Rubella?
Supportive care
