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Rubella template



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Description of Rubella/ German Measles/ Third DiseaseAcute viral infection of childhood (and adults) that may occur in two different forms: Acquired and Congenital
Risk Factors for RubellaLack of vaccination and subsequent exposure to viral particles by airborne transmission Incubation period is 14-21 days Most contagious when rash is erupting
Assessment Findings in Acquired RubellaMild catarrhal symptoms, conjunctivitis Low-grade fever Occipital lymph nodes are most commonly involved and are essentially diagnostic Lymphadenopathy; postauricular, posterior cervical Possible splenomegaly Maculopapular rash (which starts on the face and spreads to chest) which usually lasts about 3 days Possible desquamation In adults and adolescents, arthralgia and arthritis common
Assessment Findings in Congenital RubellaPremature delivery Fetal demise Low birth weight Eye defects: Cataracts, glaucoma, retinopathy Cardiac defects: PDA, ASD, VSD, Coarctation of Aorta, pulmonic stenosis Nervous System defects: Mental retardation, psychomotor retardation, encephalitis, autism, deafness Endocrine Defects: Thyroid disorder, diabetes mellitus, precocious puberty Hematological Defects: Splenomegaly, thrombosytopenia, hepatitis
Diagnostic Studies for RubellaViral Cultures from throat or urine (not usually needed) Rubella Antibodies: titer of 1:10 or higher is considered immune
Nonpharmacologic Management of RubellaSupportive care
Pharmacologic Management of RubellaUsually none needed
Pregnancy Considerations in RubellaPregnancy avoided for 1 month after vaccine Vaccine virus may be communicable through breast milk
Expected Course of Rubella50% of infections are asymptomatic Infection is early pregnancy has worse outcomes than those associated with infection after the 20th week
Consult/Referral for RubellaOB for suspected exposure during pregnancy Refer for complications Report all cases to local public health authorities



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