Congenital Rubella

8/12/2019 Congenital Rubella

1/15

CONGENITAL RUBELLA

SYNDROMEInfectious and Tropical Pediatric Division

Department of Child Health

Medical Faculty, University of Sumatera Utara


2/15

What is Rubella

Rubella (German measles) is a diseasecaused by the rubella virus. Rubella is

usually a mild illness. Most people whohave had rubella or the vaccine areprotected against the virus for the rest oftheir lives. Because of routine vaccination

against rubella since 1970 , rubella is nowrarely reported.


3/15

History - Rubella

The Teratogenic property of theinfection was documented by an

Australian opthalmologist Greeg in1941


4/15

Rubella

( German Measles )

Rubella is alsocalled as 3 dayMeasles or German

Measles. Family Togaviridae

Genus - Rubivirus

In general belongto Togavirus group


5/15

Rubella Virus

Rubella virus are

ss RNA virus

Diameter 5070 nm

Enveloped Spherical

Virus carryhemagglutinin

Virus multiply in thecytoplasam of infectedcell.


6/15

Epidemiology

Rubella is world wide in distribution

Occurs round the year,

Epidemics occur every 2025 years

Infection is transmitted by respiratoryroute

The use of Rubella vaccine has noweliminated both epidemic and endemicRubella in USA and several developedcountries


7/15

Treatment and Prevention

Rubella is a mild self limited illness.

No specific treatment or Antiviraltreatment is indicated.

However Laboratory proved andclinically missed Rubella in the Ist 3-4 months of pregnancy is associatedwith fetal infections.


8/15

Congenital Rubella Syndrome

Maternal viremia with Rubella infectionduring pregnancy may result in infectionof placenta and fetus.

The growth rate of fetal cells are reduced. Results in fewer number of cells after the

birth.

Lead to deranged and hypo plastic organ

development. Results in structural damage and

abnormalities


9/15

Rubella infection t varioustrimesters

Isttrimester infections lead to abnormalities in85 % of cases. and greater damage to organs

2ndtrimester infections lead to defects in 16 %

> 20 weeks of pregnancy fetal defects areuncommon

However Rubella infection can also lead to fetaldeaths, and spontaneous abortion.

The intrauterine infections lead to viral excretionin various secretion in newborn upto 12-18months.


10/15

Clinical Findings

( Congenital Rubella Syndrome )

May be transient effects in infants.

Permanent manifestations may beapparent at birth, becomerecognized during the first year.

Developmental abnormalities appearduring childhood and adolescents.


11/15

Classical Triad of Rubella

Classical Triad ataract ardiac abnormalities Deafness

Other manifestationsGrowth retardation

RashHepatosplenomegaly

JaundiceMeingoencephalitisCNS defects lead tomoderate to profound

mental retardation


12/15

Other Neurological manifestions

Problems in balance

Motor skills inpreschool childrenaltered.

A rare complication ofPan encephalitis canoccur in seconddecade with

Congenital rubellasyndrome mayprogress to death.


13/15

Diagnosis of

Congenital Rubella Syndrome

Demonstration ofRubella antibodies

of IgM in a newborn is diagnosticvalue. As IgMgroup donot cross

the placenta andthey are produce inthe infected fetus,


14/15

Treatment, Prevention, Control

No specific treatmentis available

CRS can be prevented by effective

immunization of the young children

and teenage girls, remain the best

option to prevent Congenital Rubella

Syndrome.

The component of Rubella in MMR

vaccine protects the vaccinated


15/15

MMR Vaccine

The MMR vaccineis a mixture of three liveattenuated viruses, administered via injection forimmunizationagainst measles, mumpsandrubella. It is generally administered to children

around the age of one year, with a second dosebefore starting school (i.e. age 4/5). The seconddose is not a booster; it is a dose to produceimmunity in the small number of persons (2-5%)who fail to develop measles immunity after the

first dose In the United States, the vaccine waslicensed in 1963 and the second dose wasintroduced in the mid 1990s. It is widely used inall National, Universal Immunization programmes
http://en.wikipedia.org/wiki/Attenuated_virushttp://en.wikipedia.org/wiki/Immunizationhttp://en.wikipedia.org/wiki/Measleshttp://en.wikipedia.org/wiki/Mumpshttp://en.wikipedia.org/wiki/Rubellahttp://en.wikipedia.org/wiki/Booster_dosehttp://en.wikipedia.org/wiki/Booster_dosehttp://en.wikipedia.org/wiki/Rubellahttp://en.wikipedia.org/wiki/Mumpshttp://en.wikipedia.org/wiki/Measleshttp://en.wikipedia.org/wiki/Immunizationhttp://en.wikipedia.org/wiki/Attenuated_virus

Documents

Congenital Rubella