Micro Winter 9 Rubeola Rubella

Front 1

Whats the dif btwn rubeola and rubella

Back 1

Rubeola- Measles, super infectious, macular- not vesiclular, starts at top and spreads down. Rubella- german measles

Front 2

Who is affected by rubeloa, measles?

Back 2

Humans only, vaccine can eradicate (like polio)

Front 3

Is rubeola tough?

Back 3

Ya! Its better though if you get it as a kid. Rubeola (measles) is 1st disease, scarlett fever is 2nd disease

Front 4

Tell me about how the infection works with classic measles, what do AB do?

Back 4

Infected cells fuse so there can be cell cell infection. AB is not fully protective. The infection gets to other tissues via monocytes viremia

Front 5

Whats the incubation on rubeola

Back 5

10-14 days, long enough to make AB but the AB aren’t fully protective. Get a prodrum

Front 6

Kopliks spots

Back 6

seen in mouth with rubeola (measles) infection- dagnostic. Also have cough, coryza and conjunctivitis

Front 7

What is the dx feature of rubeola that goes away a few days after you get the rash

Back 7

kopliks spots

Front 8

What are the “3 C’s”

Back 8

seen with rubeolla prodrum, cough, coryza and conjunctivitis NOT dx! (also see koplicks spots in mouth- these are dx)

Front 9

Ok so typical measles, what are the stages of disease

Back 9

1 prodrum: 2 week incubation, Cough coryza conjunctivitis, fever, koplicks spots. 2 Rash: sickest! Begins below ears then spreads to head and ALL over. 3. Resolution: rise in AB titer, virema stops, rash fades

Front 10

Does rubeolla get everyone!

Back 10

Oh ya! Super infectious, its better to get young. Contrast with rubella which didn’t get everyone- PROBLEM

Front 11

Ok so typical measles: you get it, you have a rash and have a fever then it resolves. What about ATYPICAL MEASLES

Back 11

infection that occurred after receiving the formalin inactivated vaccine. Rash spares face and starts with palms, soles like RMSF

Front 12

I hear that measles is NBD, why get vaccinated.

Back 12

Complications- bacterial superinfection, pneumonia, diarrhea, encephalitis, SSPE (subacute sclerosing panencephalitis), immunological abnormality. It’s a huge tax on the body and makes it more likely to get something else and decreases survivability

Front 13

What is SSPE?

Back 13

Subacute sclerosing panencephalitis- it’s a complication of rubeolla, measles

Front 14

Tell me about the rubeolla virus

Back 14

paramyxovirus, ssRNA, (-) sense, non segmented senoma (easy to make vaccine),enveloped, replication in host cytoplasm, RNA polymerase in capsid, F-fusion protein & H- hemagglutinin attachment

Front 15

Are there rubeola carriers

Back 15

nope, if you get it you have it! More common in kids.

Front 16

Who gets Rubeola-

Back 16

>6 mo<10 years (recall you are looking for Kopliks spots before the rash erupts)

Front 17

What is the infection cycle of measles in the population

Back 17

endemic, needs humans, 2-3 year endemic cycle with susceptible kids and is passed along, seen after a dry spring

Front 18

How is Measles spread

Back 18

respiratory droplets, once you get it you have it, super infections

Front 19

When can a pt with measles spread the infection

Back 19

Prodrum til 5 days after rash erupts! Very infections, respiratory droplets (and the pt has a cough!!) . can spread to lymphatics

Front 20

If you get measles as a kid what is the risk of infection later in life

Back 20

NONE! Life long immunity, vaccine requires boosters

Front 21

Measels Dx

Back 21

Kopliks spots, rash, IgM 4x increase, FA test for multinucleated giant cells (recall F protein fuses cells so it can spread)

Front 22

What is the best way to treat measles

Back 22

PREVENTION-live attenuated vaccine (need to be >1 yo and healthy)

Front 23

MMR vaccine

Back 23

live attenuated- must be over 1 and healthy. 1st dose at 1 year 2nd dose 4-6 yo. Can get monovalen for younger kids if its likely they will be exposed

Front 24

What malnutrition will make measles more severe

Back 24

vit A deficit.

Front 25

Whats Rubella

Back 25

german measles, its mild compared to rubeolla, its sometimes called 3rd disease (1st measles, 2nd scarlet fever, 3rd Rubella)

Front 26

What are the clinical manifestations of Rubella

Back 26

longer incubation than measles (2-3 weeks!!), maculopapular rash first on face then spreads down. Rash resolves in order of appearance. Fever, conjunctivitis, coryza, lymphadenopathy

Front 27

Whats the deal with rubella (genoma, virus type etc)

Back 27

Togavirus, respiratory route of infection, ssRNA (+) sence, envelope

Front 28

How is rubella spread

Back 28

less infectious than rubeola so need prolonged contact, respiratory like rubeola, common in spring

Front 29

When is a patient with rubella communicable

Back 29

5 days before and 5 days after rash! Need close prolonged contact

Front 30

Who gets rubella infection

Back 30

older kids, contrast to measles who got little kids

Front 31

What are some complications associated with rubella (recall rubella was: bacterial superinfection, pneumonia, SSPE)

Back 31

Congentical Rubella syndrome: heart, eye, ear, CNS involvement. Pts with CRS shed virus MUCH longer

Front 32

What is CRS

Back 32

congenital rubella syndrome: severe complication of rubella that affects heart, eyes, ears and brain

Front 33

What is CRS

Back 33

Congenital rubella syndrome, it’s a severe complication. Mom can pass to fetus. Heart: pulm a stenosis, PDA. EYE- cataracts, glaucoma. Hearing loss, CNS problems. Passed from mom to fetus. This is why its BAD that moms get this later in life

Front 34

Why is it bad that Rubella wont get us all when we are young.

Back 34

We grow up and get preggo and then get rubella. This increases risk of CRS for fetus. Greatest risk early in pregnancy

Front 35

What is the DDx of rubella

Back 35

HARD! Serology- IgM 4x increase

Front 36

How is rubella treated

Back 36

sx. Isolate pts for a week. Isolate infants for a year!

Front 37

If your kid has rubella when can they go back to school

Back 37

7 days after rash

Front 38

Whats the vaccine for rubella

Back 38

MMR- same as measles. Live attenuated. If we are thinking rubella we want to be sure our women of child bearing age are vaccinated. The vaccine is live attenuated so preggos cant have it (immunocomprimised)