Sunday 1 April 2012

rubella

http://en.wikipedia.org/wiki/Rubella
http://en.wikipedia.org/wiki/Congenital_rubella_syndrome

Congenital rubella syndrome features:
The classic triad for congenital rubella syndrome is:
§  Sensorineural deafness (58% of patients)
§  Eye abnormalities—especially retinopathy,cataract and microphthalmia (43% of patients)
§  Congenital heart disease—especially patent ductus arteriosus (50% of patients)
Other manifestations of CRS may include:
§  Spleenliver or bone marrow problems (some of which may disappear shortly after birth)
§  Small head size (microcephaly)
§  Eye defects
§  Low birth weight
§  Thrombocytopenic purpura (presents as a characteristicblueberry muffin rash)
Children who have been exposed to rubella in the womb should also be watched closely as they age for any indication of the following:
§  Diabetes
§  Glaucoma


Rubella 
Rubella, commonly known as German measles, is a diseasecaused by the rubella virus. 
Symtoms ,incubation period
After an incubation period of 14–21 days, German measles causes symptoms that are similar to the flu.
The primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days (that is why it is often referred to as three-day measles).The facial rash usually clears as it spreads to other parts of the body.
Other symptoms include low grade fever, swollen glands (sub occipital & posterior cervical lymphadenopathy), joint pains, headache and conjunctivitis.[6] The swollen glands or lymph nodes can persist for up to a week and the fever rarely rises above 38 oC (100.4 oF).
The rash of German measles is typically pink or light red. The rash causes itching and often lasts for about three days. The rash disappears after a few days with no staining or peeling of the skin. When the rash clears up, the skin might shed in very small flakes where the rash covered it.
Forchheimer's sign occurs in 20% of cases, and is characterized by small, red papuleson the area of the soft palate.
Rubella virus?
The disease is caused by Rubella virus, a togavirus that is enveloped and has a single-stranded RNA genome.[9] The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes. 
Diagnosis
Rubella virus specific IgM antibodies are present in people recently infected by Rubella virus but these antibodies can persist for over a year and a positive test result needs to be interpreted with caution.[12] The presence of these antibodies along with, or a short time after, the characteristic rash confirms the diagnosis.
Vaccination?
Rubella infections are prevented by active immunisation programs using live, disabled virus vaccines.
Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease.

However their use in prepubertile females did not produce a significant fall in the overall incidence rate of CRS in the UK. Reductions were only achieved by immunisation of all children.

Vaccination in children?
The vaccine is now usually given as part of the MMR vaccine.
The WHO recommends the first dose is given at 12 to 18 months of age with a second dose at 36 months.

Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus.[

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