Rubella

- German measles is viral illness and

spread by droplet infection by sneezing
and coughing and has long incubation
period 2 or 3 weeks
- Also called as 3 day measles / German
measles
- Is a disease caused by the rubella virus
-Rubella virus is usually a mild illness.

Rubella Virus Structure

Rubella virus are ssRNA virus Diametre 5070nm
Enveloped spherical
Virus carry him
hemagglutinin
Virus multiply in the
cytoplasm of infected
cell.

Pathogenisis

Pathophysiology

Pathophysiology

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Johnny Appleseed

Epidemiology
Occurs worldwide
The virus tends to peak in
countries with temperate
climates
Common in children ages 5-10
years old
Human are only known reservoir
Infection is transmitted by
respiratory route.
The use of rubella vaccine has
now eliminated both epidemic
and endemic.

Diagnosis

Many (50%) infections are apparently subclinical and

many infections go unrecognized, even if symptoms
develop (rash is not always present).
Infections with many other agents give similar
symptoms to rubella (e.g. infection with human
parvovirus, certain arboviruses, many of the
enterovirus group of piconaviruses, some
adenoviruses, EBV, scarlet fever, toxic drug reactions)
Serological tests (diagnostic test of blood serum) or
isolation of virus (immunofluorescence) are needed to
confirm infection of individual Cord blood rubella- IgM

Rubella is transmitted by droplet

spread or direct contact with
infectious patients.
Infants with CRS shed the rubella
virus in their nose, pharyngeal
secretions and urine for months or
even years.

Rubella is communicable

approximately one week before

and for at least four days after
the onset of the rash.
CRS infants may shed the virus
for months or longer after birth.
Epidemics occur every 4-9 years

Symptoms and Symptoms

Initial low grade fever -Fever rarely rises above 38 Celsius
1-2 days
Tiredness
LYMPH NODE SWELLING- Tender lymphadenopathy
(particularly posterior auricular and suboccipital lymph
nodes) persist for up to a week.
Nasal Congestion
RASH- After an incubation period , the primary symptom
of rubella virus infection is the appearance of a rash
(exanthema) on the face which spreads to the trunk and
limbs and usually fades after three days with no staining
or peeling of the skin.The skin manifestations are called
"blueberry muffin lesions."

Complications

Birth defects if acquired by a pregnant

woman: deafness, cataracts, heart defects,
mental retardation, and liver and spleen
damage (at least a 20% chance of damage
to the fetus if a woman is infected early in
pregnancy)

Treatment
There is no specific treatment. Supportive
care should be use

Prevention
The best means of preventing
rubella is vaccination with the
live cold-adapted RA27/3
vaccine strain of virus.
The live rubella vaccine is
usually administered with the
measles & mumps vaccines
(MMR vaccine) at 24 months
of age.A live vaccine
(attenuated strain) is
available.
The vaccine virus is grown in
human diploid fibroblasts.
Since there is only 1 serotype,
a univalent attenuated
vaccine can provide lifelong
immunity.

Prevention
It is important that women
are vaccinated prior to
their 1 st pregnancy.
The vaccine is
contraindicated for
pregnant women, but when
unwittingly used, no
problems have been seen.
If the patient is pregnant
and seronegative, the
pregnancy should be
monitored carefully and the
patient vaccinated
postpartum.

Measels

Measels or
Rubeola

Is an acute viral illness caused by a virus in the

family paramyxovirus genus MORBILLIVIRUS.
It is characterised by a prodrome of fever and
malaise, cough, coryza, and conjunctivitis , followed
by maculopapular rash.
Measles is usually a mild or moderately severe
illness. However, measles can result in

Pathology of measles

Epidemiology
One of the most contagious infectious diseases . Coughing, sneezing, and
talking spread measles virus in the air via respiratory droplets.
Rare under 6 months of age: transplacental IgG
Transmitted principally by direct contact with respiratory aerosols
Epidemic spread favored by crowding, a prevalence of nonimmune children,
malnutrition
In 1986 measles epidemic are linked to lack of immunisation in children or the
failure of a single dose of vaccine in many children
No reservoir other than humans
Person considered infectious during period of incubation, prodrome, and skin
rash
Single attack confers lifelong immunity
The disease begins 1 to 10 years after infection with measles virus and lasts a
few years be- fore resulting in death.

Diagnosis
Clinical diagnosis of measles requires a history of fever
of at least three days, with at leastone of the three Cs
(cough, coryza,conjunctivitis).
Signs and symptoms include fever, sore throat,
headache, dry cough, and conjunctivitis. After two days
of illness, lesions called Kopliks spots appear on the
mucous membrane of the mouth
The disease begins 1 to 10 years after infection with
measles virus and lasts a few years be- fore resulting in
death.

In patients where phlebotomy is not possible, saliva can

be collected for salivary measles-specific IgA
testing.Positive contact with other patients known to
have measles adds strong epidemiological evidence to

4 clinical signs
I- Incubation period patient is asymptotic (810 days)
P-Prodome constitutional symptoms (fever,
malaise and anorexia) . (2-8 days)
3Cs Cough, Conjunctivitis and Coyza
Koplicks spots
E - Exanthem Macupapule rash starts and
eventually disappears
R- Recovery 2 weeks of recovery

Treatment
There is no specific treatment for measles.
Most patients with uncomplicated measles
will recover with rest and supportive
treatment.
It is, however, important to seek medical
advice if the patient becomes more
unwell, as they may be developing
complications. Patient should be
monitored for the development of
bacterial infections which should be
treated with appropriate antibiotics on the
basis of clinical and bacteriological
finding

Treatment
The patient may also take over-the-counter medications such as
acetaminophen (Tylenol, others) or non steroidal anti-inflammatory
drugs (NSAIDs) to help relieve the fever that accompanies measles.
VITAMIN A and Ribavirin IV
Maintain bedrest and provide quiet activities for the child. If there is
sensitivity to light, keep room darkly lit.
Remove eye secretions with warm saline or water. Encourage the
patient not to rub the eyes.
Administer antipyretic medication and tepid sponge baths as ordered.
A cool mist vaporizer can be used to relieve cough. Apply antipruritic
medication to prevent itching.
Isolate child until fifth day of rash.

Prevention
Avoid exposing children to any person
with fever or with acute catarrhal
symptoms

Isolation of cases from diagnosis until

about 5-7 days after onset of rash

Disinfection of all articles soiled with

secretion of nose and throat

Vaccination is the most practical,
economical, and enduring strategy to
combat measles
Live attenuated and inactivated
measles virus vaccines have been
tested and are available for use in
children with no history of measles, at

Other Viral Rashes

Erythema Infectiosum
A case of erythema
infectiosum (fifth
disease). Distinct
reddening of facial skin
that resembles the
result of a slap is
characteristic of this
parvovirus-caused
disease.
A common and highly
contagious childhood
ailment causing a
distinctive face rash

The rash of erythema infectiosum begins

on the cheeks and spreads to the arms,
thighs, buttocks, and trunk. The facial rash
appears as if the patient has been
slapped.
Sunlight aggravates the rash at all stages;
earlier lesions fade as the disease
progresses, though they can reappear
when the patient is exposed to sunlight.
Infected adults who missed the disease in
childhood may suffer anemia, joint pain,
and rarely miscarriage in addition to the
rash.

Treatment
Treatment involves
use of non steroidal
anti-inflammatory
drugs (NSAIDs).

Roseola
A common viral infection
in young children that
may cause high fever and
a rash.
Characterised by an
abrupt fever, sore throat,
enlarged lymph nodes,
and a faint pink rash on
the face, neck, trunk, and
thighs.
Symptoms include several
days of high fever,
followed by a rash. The
rash may appear as many
small pink spots.

Treatments

Treatment includes bed rest, fluids, and

medications to reduce fever.

Self-treatment
Anti-inflammatory: Ibuprofen (Advil)
Pain reliever: Acetaminophen (Tylenol)
Also common
Lifestyle: Fluid replacement
Soothing remedies: Bed rest