Rubella Flashcards
(25 cards)
True or false: rubella is nationally notifiable?
True - routine.
Which organism causes rubella?
Rubella virus
Also called German measles or 3 day measles.
Rubella etymology - latin = “little red”
How is rubella transmitted?
Person-person:
* Respiratory droplets
* Direct contact secretions
* Vertical
What are the clinical features of rubella?
Spectrum
* Asymptomatic
* Prodrome - headache, malaise, coryza
* Febrile illness with diffuse rash
* Cervical lymphadenopathy
What are the clinical complications of rubella?
- Polyarthralgia
- Encephalitis
- Adverse pregnancy outcomes (stillbirth, miscarriage, CRS) - rare if infected after 20 weeks
CRS = congenital rubella syndrome
What is congenital rubella syndrome?
- Opthalmic (cataracts, congenital glaucoma)
- Auditory - SNHL
- Neurological - microcephaly, meningo-encephalitis
- Cardiac - PDA, pulmonary stenosis
- IUGR
- Pneumonitis
- Hepatosplenomegaly
- Thrombocytopaenia
- Radioluscent bone disease
Which groups are high-risk for rubella?
Pregnant women
What are the case definitions for rubella?
Rubella:
* Confirmed: Isolation/detection/seroconversion
* Probable - IgM + clinical/epi
Rubella congenital - confirmed and probable
CRS - confirmed and probable
How is rubella diagnosed?
Culture or PCR from NPA, urine, saliva, amniotic fluid, blood
Serology
What is the incubation period for rubella?
14 - 17 days (up to 21 d)
What is the infectious period for rubella?
7 days before to 4 days after rash onset.
Infants with CRS shed for months or longer.
What is the outbreak definition of rubella?
Eliminated in Australia therefore observed > expected.
How are outbreaks of rubella managed?
How is rubella prevented?
Vaccination - 2 doses on NIP at 12mo (MMR) and 18 mo (MMRV)
What type of vaccine is the rubella vaccine?
MMR / MMRV is a live-attenuated vaccine.
Apart from those indicated on the NIPS, who should receive the rubella vaccine?
- All adults and adolescents without prior doses especially HCW, ECE
- Seronegative WCBA
Seronegative WCBA shoyld have repeat serology 6-8 weeks post vaccine (avoid pregnancy 28 days)
True or false: the rubella vaccine confers lifelong immunity?
True.
What resources are available for public health management of rubella?
No SoNG.
DH protocol.
How are cases of rubella managed?
- Interview: DRSVECT - sx, vax, antenatal screening if CRS, contact with pregnant women while infections
- Treatment - clinician
- Isolation/exclusion - exclude W/S/CC other settings with children and pregnant women for 4 days from rash onset.
- Educate re transmission, importance of immunisation
Who are considered contacts of rubella cases?
- HH
- Same calss
- Same social function
- Work in same area
Who are high-risk contacts of rubella cases?
Pregnant women.
How are contacts of rubella managed?
Susceptible (non-immune) - MMR vaccine (though unlikely to reduce risk of infection)
Pregnant women
* Urgent serology, obstetric referral for Mx/counselling
* Avoid contact with case and other contacts for 6 weeks
* Consider NHIg
Systematic approach:
* Treatment - vax, pregnant women as above
* Isolation / Exclusion - HCWs - if no immunity exclude from work for 21 days post exposure
* Monitor -
* Education - Sx, avoid contact with high-risk until 21d after exposure
What environmental management is required for rubella?
Nil
True or false: rubella is common in Australia?
False. Eliminated in Australia (2018) due to widespread vaccination.
Previously common and major cause of congenital abnormalities and deafness.
