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20 Cards in this Set
- Front
- Back
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What is the other came for rubella?
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German Measles
also known as ROSEOLA |
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What is the name for regular measles?
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Rubeola
From Morbillivirus |
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What is the incubation time for rubella? and when are you most infectious?
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incubation time is 12-23 days
infectious 1 week before and 1 week after |
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what are the classic features of rubella?
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Scarletiniform rash - begins on face, then spreads to adjacent areas trunk/extremities --> usually resolves within 3 days
Polyarteritis - 1 week after the rash |
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is it possible to get congenital rubella syndrome after you've already had the disease before?
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Yes - you are normally provided with natural immunity, but rarely re-infection can cause issues
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how do you diagnose maternal infection with Rubella?
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Serology:
IgM and IgG IgM - will give acute onset and first infection IgG will usually show in the convalescent period (can be done either 2 weeks after first serum Maternal culture - viral culture from Nasal, blood, throat - best within 1 week of rash |
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why is Rubella the big bad guy if obtained in the first trimester?
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one of the WORST teratogens known
80% will get congenital rubella syndrome if infected in the first trimester |
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what are ways that we can test the fetus?
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US - very difficult to see and occasionally unreliable
CVS - 10-12 weeks Amniotic fluid - 14-16 weeks FEtal blood - 18-20 weeks |
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what are the manifestations associated with congenital rubella syndrome?
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Ears - sensorineural deafness
Eye -cataracts, blindness, retinopathy, microophthalmia, glaucoma CVS - VSD, PDA, Pulmonary artery stenosis CNS - MR, ventriculomegaly, microcephaly, intra-cranial calcifications Others - Hepatsplenomegaly, IUGR, low platelets, radiolucent bone disease, blueberry muffin rash |
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What is the common Congenital rubella manifestation?
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sensorineural deafness
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what are some features of late spectrum rubella syndrome?
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may not see till 2nd or 3rd decade of life
Diabetes, thyroiditis, panencephalitis, behavioural issues, growth hormone deficiency |
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Describe the risk of transmission to the fetus depending on the time point
When is the congenital rubella risk the worst? What are the risks after that? |
<12 weeks - 80%
end of T2 - 25% 27-30 weeks - 35% 36 weeks - close to 100% congenital Rubella worst before 20 weeks After 20 weeks, then will see IUGR, sensorineural deafness and MR |
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what are the risks of congenital rubella syndrome depending on the time frame?
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11 weeks - 90% CRS
11-12 weeks- 33% 13-14 weeks - 11% 15-16 weeks - 24% after 16 weeks - close to zero! |
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is the MMR vaccine okay to give to pregnant women?
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No - it is a live attenuated vaccine - even though there are no anomalies noted with the delivery of the vaccine, we don't want to take the risk
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What do you do if there is inadvertent vaccination?
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no need to terminate the pregnancy
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what are some side effects of the vaccine? is there any vaccine failure?
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5% vaccine failure - will usually have protection for >18 years
SE: arthritis, arthralgia, fever, rash, adenopathy, no association with autism |
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what are some contraindications to the vaccine?
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acute severe illness, immunodeficiency, pregnancy, history of anaphylaxis to neomycin
DON"T get pregnancy for 28 days after the vaccine |
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what happens if you have re-infection after known immunity? and this is before 12 weeks
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test serology - if risk in IgG but NO IgM then risk of congenital infection --> 8% need to counsel
can consider termination? if >12 weeks and known to be immune then reassure - NO known CRS |
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what if the patient is non-immune or immunity is unknown?
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<16 weeks - draw immediate serum then convalescent serum - (2 weeks if rash, 5-6 week if no illness)
Can offer pregnancy termination 16-20 weeks - CRS is rare and counsel (<1%) - draw titres - child may have deafness >20 weeks - no CRS so reassure - Monitor for IUGR MAKE Sure you have really good gestational dating |
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What do you need to do for the children who end up with congenital varicella?
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the children are infectious and may shed virus for many months - need to be careful because it can affect the adults
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