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Rubella virus

a. German measles/ 3-day measles
  1. Genus: Rubivirus
  2. Belongs to Togaviridae family not a paramyxovirus
  3. Spherical, 70nm diameter, positive sense, single stranded RNA, enveloped
  4. Not transmitted by arthropods
    1. Mild child hood fever
    2. May also be acquired congenitally or postnatally
    3. Postnatal rubella-Virus excreted in oropharyngeal secretions and infection is acquired by inhalation
      1. Virus multiplies locally in upper respiratory tract & cervical lymph nodes→  viraemia, dissemination throughout the body
      2. Incubation period: 2-3 weeks. fine pink macules first appearing on the face and then spreading to involve trunk and limbs and Enlargement of postauricular, suboccipital, posterior cervical lymph nodes
      3. Recovery within 3-4 days of appearance of rash
      4. Complications: polyarthritis (adult women, thrombocytopenic purpura, encephalopathy, panencephalitis)
  • Congenital rubella
  1. Virus can cross the placental barrier and infect the foetus
  2. Congenital defects: deafness, cataract, glaucoma, microphthalmia, retinopathy, congenital heart disease (patent ductus arteriosus, pulmonary artery stenosis), microcephaly, mental retardation, thrombocytopenic purpura, hepatosplenomegaly
  3. Timing of fetal infection determines the extent of teratogenic effect
  4. Infection in first trimester: abnormalities in 85% cases
  5. Infection in second trimester: abnormalities in 16% cases
  6. Infection after 20 weeks of gestation: birth defects uncommon
  • Laboratory diagnosis
  1. Isolation: tissue culture, detection by immunofluorescence, immunoperoxidase staining
  2. Serology: IgM antibodies, ELISA, RIA
  3. Prophylaxis-Live attenuated vaccine, RA 27/3 strain

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