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RUBELLA (CONGENTINAL (DIAGNOSIS (Viral culture / serology testing
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RUBELLA
CONGENTINAL
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Systemic upset
- Jaundice
- Purpura
- Hepatomegaly
DIAGNOSIS
- Viral culture / serology testing
- Nasopharyngeal swab, urine, CSF and WBC
- Antibody screening (ELISA, IFA)
- CXR
- Echocardiography
- CT scan of head
- MRI
CLINICAL FEATURES
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Prodromal period
- Fever, malaise
- Lymphadenopathy from 1 week before rash (suboccipital, postauricular and cervical)
Rash
- Maculopapular
- Face first, then rapidly to trunk than limbs
- Usually lasts <3 days
COMPLICATION
Arthralgia
- 70% of adult women (rare in other groups)
- Lasts 3-4 days (occasionally few weeks)
- Especially fingers wrists knees ankles
Congenital Rubella Syndrome
- Before 12 weeks gestation 75% risk of severe malformation
- 13-16 weeks - risk is mainly of sensorineural hearing loss
DIAGNOSIS
Antibody screening (ELISA, IFA)
- Rubella-specific IgM in a single serum sample
- Rubella-specific IgG for past infection / vaccination
Viral culture
- Time consuming and expensive
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EPIDEMIOLOGY
- rubella virus
- (+) strand RNA virus
- Transmitted by respiratory droplets and from mother to fetus transplacentally
- Incubation period 14-21 days (to rash onset)
- Infectious 7 days before rash to 7 days after it appears