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Cause:
Rubella virus, a togavirus, genus Rubivirus.
Illness and treatment:
Acquired rubella is usually mild with fever and a
maculopapular rash moving down from the face to include the
entire body. Up to 50% of infections are inapparent. Older
children and adults may have malaise, lymph node swelling,
and upper respiratory symptoms before the rash. Arthritis
and arthralgia are frequent in adults. Complications
including encephalitis (1 in 6000 cases) are uncommon and
occur more often in adults. Congenital rubella syndrome
(CRS) can result if a woman acquires rubella during
pregnancy, especially in the first trimester. The virus may
cause a variety of congenital malformations, most commonly
deafness. Fetal death, spontaneous abortion, or premature
delivery may occur.
Sources:
Humans are the reservoir.
Infants with CRS can shed virus for an extended period, but
a true carrier state does not occur. Transmission is through
airborne or droplet spread of the respiratory secretions of
infected persons, including asymptomatic and subclinical
infections.
Additional risks:
Since 2004, rubella is no longer endemic in the United
States. Most reported rubella cases in the country are now
among Hispanic adults born in areas where rubella vaccine is
not routinely used or infants of Hispanic women who were
themselves born outside the United States. Adults are more
likely than children to have encephalitis or develop
arthritis.
Prevention:
Universal childhood
immunization prevents infection. Respiratory and hand
hygiene can prevent transmission.
Recent Washington trends:
Between 0 and 8
cases of acquired rubella are reported annually. In 2000, an
infant with CRS was born in Washington to a Hispanic mother
born outside the United States. This was the only CRS case
reported in the state in the past 20 years.
2008:
No cases were reported.
Purpose of Reporting and
Surveillance
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To prevent congenital rubella
syndrome (CRS)
- To
assure that children with suspected CRS are tested to
confirm or rule out the diagnosis in a timely manner in
order to assure prompt treatment and prevent spread of the
disease
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To assure that acquired rubella
cases are tested to confirm or rule out the diagnosis. (As
part of the proposed Healthy People 2010 objectives,
a goal was established to eliminate U.S.-acquired rubella
and CRS in the United States by the year 2010)
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To identify exposed pregnant
women in a timely manner, determine their susceptibility and
infection status, and provide appropriate counseling about
the risk of fetal infection
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To evaluate the effectiveness
of disease prevention efforts such as immunization
Legal Reporting Requirements
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Health care providers:
immediately notifiable to local health jurisdiction
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Hospitals: immediately
notifiable to local health jurisdiction
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Laboratories: no reporting
requirements
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Local health
jurisdictions: notifiable to the Washington State
Department of Health (DOH) Communicable Disease
Epidemiology Section (CDES) within 7 days of case
investigation completion or summary information required
within 21 days
Last
update
November 2009 |
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