Eruptive Fever Diseases: German Measles (Rubella; 3-day Measles)

Definition:
A mild viral illness caused by rubella virus.
It causes mild feverish illness associated with a rash, and aches in joints.
It has teratogenic effect on the fetus.
Infectious agent:
Rubella virus (Family – Togaviridae; Genus Rubivirus)
Incubation period:
From exposure to the appearance of rash, is usually 14-21 days.
Period of communicability:
•    Approximately one week before and four days after the onset of rashes, but is at its worst when the rash is at its peak.
•    Highly communicable infants with congenital Rubella may shed virus for months after birth.
Mode of transmission:
o    Direct contact with nasopharyngeal secretions.
o    Air droplets
o    Transplacental in congenital rubella.
o    Infants with congenital rubella shed large quantities of virus in their pharyngeal secretions and urine which serves as source of infections to other contacts.
Clinical manifestations:
I.  Prodromal period
•    Low grade fever
•    Headache
•    Malaise
•    Mild coryza
•    Conjunctivitis
•    Post-auricular, sub-occipital, and posterior cervical lymphadenopathy which occur on the 3rd to the 5th day after onset.
II. Eruptive period
•    A pinkish rash on the soft palate (Forschheimer’s spot)
•    An exanthematous rash that appears first on the face spreading to the neck, the arms, trunk and legs.
•    Eruption appears after the onset of adenopathy
•    Children usually present less or no constitutional symptoms.
•    The rash may last for 1 – 5 days and leaves no pigmentation, no desquamation.
•    Testicular pain in young adults.
•    Transient polyarthralgia and polyarthritis may occur in adults and occasionally in children.

Modalities of treatment:
•    Very little treatment is necessary: it is essentially symptomatic


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