Rubella
| No known endemic spread in UK and US thanks to vaccinations | |
|---|---|
| Etiology | togavirus = positive stranded RNA virus Transmission: direct or droplet contact with infected body fluids |
| Epidemiology | Incubation period - 12-23 days, figures vary Infectious from 1 week before to 4 days? after the onset of rash |
| Clinical presentation | Maculopapular rash - begins on face and spreads to hands/feet; lasts 3-4 days Palatal petechiae, nontender lymphadenopathy Arthalgia Forschheimer spots: pinpoint macules + petechiae in soft palate and uvula Complications: encephalitis, thrombocytopenia |
| Diagnostic investigations | salivary IgM rubella-specific IgM serum antibody |
| Management | Notifiable disease School exclusion - 5 days from onset of rash AVoid pregnancy until 3/12 after imms |
post exposure prophylaxis
congenital rubella
- most dangerous when exposed in 1st trimester
- placental-fetal transmission
- sensorineural deafness, cataracts, microcephaly, IUGR
- insufficient evidence for normal immunoglobulin for prevention of congenital rubella in the fetus