Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild with half of the people not realizing that they are infected. A rash may start around two weeks after exposure and last for three days.

1. Rubella
German measles
Rubella virus is
the sole
member of the
genus Rubivirus
in the family
Togaviridae.
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2. Rubella Viruses
• Rubella virus is a spherical, 40- to 80-nm,
• positive-sense, single-stranded RNA virus with spike-like,
hemagglutinin-containing surface projections.
• An electron-dense 30 to 35 nm core is surrounded by a
lipoprotein envelope.

3. Rubella Viruses
Rubella virus is the sole member of the genus Rubivirus in the family Togaviridae.

4. Rubella Virus - Multiplication

5. Rubella Virus - Multiplication
+ strand
parental RNA
Non structural
proteins like
RNA polymerase
- strand
parental RNA
+ strand
progeny RNA
+ mRNA
Structural
proteins like
capsids
Ribosome
RNA pol Ribosome

6. Rubella - Symptoms
Symptoms normally appear 14 to 21 days after infection.
The rash often starts on the face and moves to the trunk and limbs. After 3 to 5 days, it
fades and disappears. It can be itchy.
Other symptoms include:
• a stuffy or runny nose
• headache
• a mild fever
• red, inflamed eyes
• nerve inflammation
• enlarged and tender lymph nodes
• aching joints

7. Rubella - Symptoms
Though infection can happen at any age,
Rubella rarely affects young infants or people
over 40 years. A person who is infected with
rubella at an older age will normally have more
severe symptoms.
Rubella is also called as third day measles or
German measles
Skin rashes due to rubella infection

8. Congenital rubella syndrome
The rubella virus can pass through the placenta and move
through the fetal circulation. It can destroy cells or prevent them
from dividing. This causes congenital rubella syndrome.
Congenital rubella syndrome occurs when a pregnant woman contracts the rubella virus, and
it passes through the placenta to the unborn child.
This can trigger a loss of pregnancy or stillbirth, or it can cause
severe damage to the developing fetus, especially eye problems,
hearing problems, and heart damage.

9. Congenital rubella syndrome
These effects on the infant can include:
• Deafness
• hearing impairment
• cataracts
• congenital heart disease
• Conjunctivitis
• anemia
• hepatitis
• developmental delay
• damage to the retina, known as retinopathy
• an unusually small head, lower jaw, or eyes
• liver, spleen or bone marrow issues, which
sometimes disappear shortly after birth
• low birth weight
Other conditions may appear as the child
develops. These might include:
• Autism
• Schizophrenia
• learning difficulties
• type 1 diabetes
Classical
Triad of
Rubella

10. Congenital rubella syndrome
Cataract in infant due to
congenital rubella syndrome
CRS and rubella infection is
almost always have a prevalent
conjunctivitis

11. Diagnosis
• The occurrence of the typical rash and lymph node enlargement may suggest
the diagnosis of rubella.
• Laboratory diagnosis of rubella is typically made by using serologic studies
(i.e., detection of IgM and/or fourfold antibody rises).
• The presence of specific IgM antibodies indicates recent rubella infection.
• Congenital rubella in the neonate is diagnosed by virus isolation or blood
testing. The affected neonate has circulating antibodies, including
transplacentally acquired maternal IgG antibody and actively produced fetal
and neonatal IgM antibody. Maternal IgG antibody is detectable in the
neonate and wanes during the first 6 months of life. Therefore, the
persistence of IgG antibody beyond 6 months or the demonstration of IgM
antibody is diagnostic for congenital rubella infection .

12. MMR Vaccination
The only way to prevent the contraction of
rubella is through vaccination.
Taken with the measles and mumps vaccination,
the rubella vaccine prevents transmission.
The vaccine comes in the form of a live attenuated,
or weakened, virus. It is delivered at 12 to 15
months of age with a second dose at 4 to 6 years.
Any adult who has not yet had the measle, mumps,
and rubella (MMR) vaccine should receive it.

13. MMR Vaccination / Side effects
Side effects of the vaccine are minimal.
Around 15 percent of people will have a mild fever
around 7 to 12 days after the injection, and 5
percent will develop a minor rash.
Teenage or adult women may experience joint
aches. Fewer than 1 in 1,000,000 have a severe
reaction.
There is no link between the MMR vaccination and
autism. The dangers of not being vaccinated are
higher than the danger posed by any adverse
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