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EPIDEMIOLOGY OF RUBELLA
This document discusses the epidemiology of rubella, also known as German measles. It is caused by the rubella virus, which is transmitted through respiratory droplets. Rubella usually causes a mild infection in children under 10 years old, characterized by low fever and a rash. However, infection during early pregnancy can lead to serious birth defects in the fetus known as congenital rubella syndrome. Vaccination with the MMR vaccine is recommended to prevent rubella infection and protect pregnant women.
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EPIDEMIOLOGY OF RUBELLA
- 1. EPIDEMIOLOGY OF RUBELLA (GERMAN MEASLES) DR.MAHESWARI JAIKUMAR. [email protected]
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- 6. RUBELLA/GERMAN MEASLES • Germanmeasles is an acute childhood infection, usually mild, of short duration (3 days).
- 7. • Rubella isaccompanied by low grade fever, lymphadenopathy and a maculopapular rash. • Infection in early pregnancy may result in serious congenital defects including death of the fetus.
- 10. AGENT • Rubella iscaused by an RNA virus of the TOGAVIRUS family. The virus can be propagated in cell culture.
- 12. SOURCE OF INFECTION •Clinical or subclinical case of cases of rubella. ( A large number of rubella infections are subclinical. This is one of the major differences between measles and rubella)
- 13. PERIOD OF COMMUNICABILITY • Rubellais much less communicable than measles (due to absence of coughing).
- 14. • The periodof communicability probably extends from a week before symptoms to about a week after rash appears. Infectivity is greatest when the rash is erupting.
- 16. AGE • Mainly adisease of childhood. • Usually affects children between 3 & 10 Years.
- 17. IMMUNITY • One attackresults in lifelong immunity. • Secondary attacks are rare.
- 19. • Disease usuallyoccurs in a seasonal pattern. • In temperate zones during the late winter and spring, with epidemics every 4-9 years.
- 20. TRANSMISSION • The virusis transmitted directly from person to person by droplets from nose and throat and droplet nuclei (aerosols) from one week before the onset of rashes to one week after it has faded.
- 21. • The portalof entry is through respiratory tract. • The virus can cross placenta (vertical transmission).
- 22. INCUBATION PERIOD 2 To3 weeks; average 18 days.
- 23. CLINICAL FEATURES • Alarge percentage of infections are asymptomatic. • However in a typical case, the clinical features compromise the following.
- 24. PRODROMAL • The prodromalsymptoms are coryza, sore throat, low-grade fever mark the of viraemia.
- 25. LYMPHADENOPATHY • In susceptibleindividuals, the enlargement of the post auricular and posterior cervical lymph node appears as early as 7 days before the appearance of the rash.
- 26. • The enlargedglands may be found 10-14 days after the rash.
- 27. RASH • The rashis often the first indication of the disease in children. • It appears first on the face, usually within 24 hours of the onset of prodromal symptoms.
- 28. • It isa minute, discrete, pinkish, macular rash and not confluent as the rash of measles. • Conjunctivitis may occur.
- 29. • The rashspreads rapidly to the trunk and extremities, by which time it is often no longer apparent on the face. • The rash spreads much faster and clears more rapidly than the rash of measles.
- 30. • It disappearsaltogether by the third day. • The rash is an inconstant feature of the disease. • It is absent in subclinical cases.
- 31. COMPLICATIONS • In rareinstances arthralgia may occur in several joints in adults. • Thrombocytopenic purpura has also been observed as a complication.
- 32. DIAGNOSIS • Due toits mildness and variability of symptoms, the disease can go unrecognized unless it is an epidemic. • A definitive diagnosis of rubella is possible only through virus isolation and serology.
- 33. • Throat swabsshould be cultured for virus isolation; it takes longer than serological diagnosis. • The most widely used serological test is the heamagglutination inhibition test (HAI).
- 35. • Two bloodsamples are taken , the first sample within 5 days after the onset of illness, and the second 2 weeks later. • More sensitive serological test include the ELISA test and radioimmunoassay.
- 36. CONGENITAL RUBELLA • CongenitalRubella Syndrome (CRS) refers to infants born with defects secondary to intrauterine infection or who manifest symptoms or signs of intrauterine infection sometime after birth.
- 38. • Rubella infectioninhibits cell division and this is probably the reason for congenital malformations and low birth weight.
- 39. • The classicaltriad of congenital defects are deafness, cardiac malformations and cataracts. • Other resulting defects include glaucoma, retinopathy, microcephalus cerebral palsy, IUGR,hepato-splenomegaly, and mental and motor retardation.
- 40. • These defectsoccurring singly or in combination have become known as “Congenital rubella Syndrome”.
- 42. • The firsttrimester of pregnancy is crucial and disastrous for the foetus as the organogenesis takes place. Maternal infection during this time is directly associated with congenital abnormalities.
- 43. PREVENTION • Active immunizationis available. • RUBELLA VACCINE : RA 27/3 vaccine, produced in human diploid fibro-blast is recommended for prevention.
- 44. • RA 27/3vaccine is administered in a single dose of 0.5ml subcutaneously. • It may provoke some mild reactions in some subjects such as malaise, fever, mild rash and transient arthralgia, but no serious disability.
- 45. • Rubella vaccineis also available as combined Measles, Mumps and Rubella (MMR). • It is equally effective.
- 48. VACCINATION STRATEGY • MMRvaccination is given to infants on completing 9 months of age. (in the national immunization schedule in India)
- 49. • In generalthe priority being to protect women of child bearing age (15-34 or 39 years of age) and then to interrupt transmission of rubella by vaccinating all children in the community aged 1-14 years and subsequently all children at one year of age.
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