Mode of transmisison: droplets, infants with congenital rubella syndrome: shed rubella virus in pharyngeal secretions

Incubation: 14-23d

Period of infectivity: 7 days before until 7days after

Vaccines:  live attenuated

• MMR

women who are pregnant should know their immune status (\<10 - should receive MMR

Schedule: 15mo and 4yrs

efficacy: highely effective

• enveloped RNA virus

Clinical

• features

  • transient erythematous rash

  • lymphadenopathy

  • without respiratory symptoms

  • arthritis/arthraligia relatively ommon

  • may be clnically indistinguishable from measles

  • Encephalitis - 1/6000

  • thrombocytopenia occurs rarely

  • maternal rubella in first 8 weeks

    • foetal damage in up to 85%

    • multiple defects are common

      • cataracts

      • nerve deafness

      • cardiac malformations

      • microcephaly

      • mental retardation

      • behavioural problems

• pregnancy:

  • screened

  • if \<10iu/ml

    • avoid situations in early pregnnacy where contact with rubella is more likley

      • overseas travel

      • outbreask

    • MMR after delivery

    • if MMR and anti-D

      • given at same time

      • doens’t interfere with antibody

      • whole blood does in up to 50%

    • check serology 6-8/52 after - given further dose if no seroconversion

    • no risk breastfeeding