ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Rubella Viral Infection: Epidemiology, Clinical Features And Diagnosis

Updated on March 25, 2014

Clinical Features Of Congenital Rubella


Epidemiology And Pathogenesis

Rubella is an exanthema caused by an RNA virus (50 to 85 nm in size) belonging to the family of togaviruses. The disease is characterized by mild constitutional symptoms and rash. Its importance is due to the risk of producing fetal abnormalities and abortion if it occurs in women during the early months of pregnancy.

Epidemiology: The infection spreads through droplets and entry is through the nasopharynx. Infective period starts one week before the onset of the rash and it lasts for one week after the rash fades. Virus is present in the nasopharyngeal secretion one week before the onset of the illness. In the early stage, viremia occurs. The virus reaches the fetus through the placenta and causes lesions in the fetus. The baby sheds the virus at birth and continues to be infective for 6 to 31 months. The disease is prevalent in the community and small epidemics may occur from time to time. Many cases may be subclinical . An attack confers lifelong immunity. In Western countries, it is estimated that 10 to 15% of adult women are susceptible to infection. In India, the disease is not infrequent, though reliable statistically figures are not available.

Pathogenesis: The virus is present in blood up to two days before the onset of the rash. Lymph nodes are moderately enlarged, showing edema and hyperplasia. When the fetus is affected, the virus multiplies in the liver, spleen, bone marrow and other tissues and leads to various structural malformations in the heart, nervous systems, eyes and the limbs.

Congenital Rubella

Rubella embryopathy results either from inhibition of cell growth or cellular necrosis. Fetal defects include retardation of growth, eye defects like cataract, glaucoma or retinopathy, heart lesions, deafness, mental retardation, hepatosplenomegaly and skeletal abnormalities.

Physical Presentation Of Rubella


Clinical Manifestations And Diagnosis Of Rubella

Clinical Manifestations

The incubation period is usually 2 to 3 weeks. The onset is sudden with malaise, fever, rashes and characteristic enlargement of the occipital, posterior auricular and posterior cervical glands.

The rash which resembles that of measles begins on the face and neck and spreads to the trunk and limbs. Compared to measles, the rash is less extensive. Enanthema may occur consisting of discrete rose coloured spots on the palate and fauces. The rash becomes discrete by the second day and it disappears in 3 to 4 days.

Compared to measles, constitutional symptoms are mild in children. In addition to fever and malaise, arthralgias, joint stiffness and headache may occur. Rarely, serious neurological complications like encephalitis, encephalomyelopathy or polyneuropathy develop 5 to 10 days after the onset. Thrombocytopenia may develop in a few.


Clinically, the disease should be suspected when fever, posterior cervical lymphadenopathy and rash occur in a young subject. Rubella has to be distinguished from measles, secondary stage of syphilis, drug rashes, infectious mononucleosis and ECHO. Coxsackie and adenovirus infections. The leucocyte count is normal in rubella. Specific diagnosis is established by finding a four-fold increase in hemagglutination inhibition antibodies in paired sera or by isolating the virus.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)