Also known as German measles or three-day measles,

An infection caused by the rubella virus, a togavirus that is enveloped and has a single-stranded RNA genome.

It is spread through the air.

Rubella occurs worldwide.

Rubella is usually spread through the air via coughing of people who are infected.

The virus is transmitted by the respiratory route and replicates in the nasopharynx and lymph nodes.

People are infectious during the week before and after the appearance of the rash.

During the incubation period, the patient is contagious for about one week before he/she develops a rash and for about one week thereafter.

Only humans are infected.

Rubella can affect anyone of any age.

Often mild with half of people not realizing that they are infected.

It is associated with a rash that starts around two weeks after exposure and last for three days.

The rash usually starts on the face and spreads to the rest of the body.

The rash is less bright and intense as the rash with measles.

The rash is sometimes itchy.

The rash disappears after a few days with no staining or peeling of the skin.

Adenopathy is common and may last weeks.

Swollen lymph glands in the sub-occipital and posterior cervical area may occur.

A fever, sore throat, and fatigue may also occur, and adults may experience joint pain.

Coryza in rubella may convert to pneumonia, either viral pneumonia or secondary bacterial pneumonia, and bronchitis.

In 20% of cases Forchheimer’s sign occurs, characterized by small, red papules on the area of the soft palate.

Complications include: bleeding problems, testicular swelling, headache, conjunctivitis, inflammation of nerves, and congenital rubella syndrome or miscarriage.

Adult women are particularly prone to arthritis and joint pains.

Infection during early pregnancy may result in a child born with congenital rubella syndrome or miscarriage.

Babies with CRS may spread the virus for more than a year.

Diagnosis is confirmed by finding the virus in the blood, throat, or urine, antibody tests.

Following infection patients are immune to future infections.

It is preventable with the rubella vaccine with a single dose being more than 95% effective.

The rubella vaccine is usually given in combination with the measles vaccine and mumps vaccine, known as the MMR vaccine.

Once infected there is no specific treatment.

Each year about 100,000 cases of congenital rubella syndrome occur.

In April 2015 the World Health Organization declared the Americas free of rubella transmission.

The development of polyarthritis and polyarthralgia is the most common complication of rubella infection, affecting up to 70% of adolescents and adult women.

Universal immunization produces a high level of herd immunity is important in the control of epidemics of rubella.

In 1969 a live attenuated virus vaccine was licensed, and in the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced.

It is the third disease to be eliminated from the western hemisphere with vaccination after smallpox and polio.

Before immunization programs rubella epidemic 1962-1965 associated with 12.5 million cases including 20,000 children with congenital rubella syndrome and 2100 neonatal deaths.

No recent documented cases in the U.S.

Encephalitis develops in 13 of 100,000 patients.

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