Rubella (German Measles)
VINCE REV P. MORALES
BSN 1 - A
TAXONOMY
Kingdom: Orthornavirae
Phylum: Kitrinoviricota
Class: Alsuviricetes
Order: Hepelivirales
Genus: Rubivirus
Family: Matonaviridae
Common names: German measles or 3-day measles
GENERAL CHARACTERISTICS
Rubella is usually mild but can cause serious complications, especially in
pregnant women.
In pregnant women, rubella can cause miscarriage, stillbirth, or
congenital rubella syndrome (serious birth defects).
Incubation period: 17 days on average (range: 12-23 days).
Most contagious when the rash appears.
Contagious period: 7 days before to 7 days after the rash appears.
MORPHOLOGY
Envelope Glycoproteins:
E1: Primary glycoprotein for virus attachment and entry into host cells;
induces neutralizing antibodies.
E2: Works with E1 for cell entry and immune modulation.
Capsid Protein:
Forms protective icosahedral shell around viral RNA.
Aids in virion assembly within host cell.
Replication Cycle:
Virus attaches to host cell via glycoproteins, enters via endocytosis.
Viral RNA released, used for replication and protein synthesis.
New virions assembled in cytoplasm, released through budding.
EPIDEMIOLOGY
Global reported rubella cases declined by 97% from 2000 to 2018, from
670,894 to 14,621 cases.
Rubella remains the leading cause of vaccine-preventable birth defects, with
approximately 100,000 infants worldwide born with CRS each year.
In the Philippines, there has been a concerning increase in measles and
rubella cases, with 2,594 cases reported in the first 11 months of 2023, a
335% increase compared to the same period in 2022.
In 2024, the DOH reported 1,627 cases of measles-rubella (MR) in the country
from January 1 to April 6, with four deaths recorded.
Susceptible Host:
Agent:
Unvaccinated individuals
Rubella virus
Pregnant women Reservoir:
Travellers Humans
Individuals with weak
immune system
CHAIN OF
INFECTION Portal of Exit:
Nasal and throat secretions
Portal of Entry: Urine (in infants with CRS)
Respiratory lining of
the nasopharynx Mode of Transmission:
Direct contact
Droplet transmission
Vertical transmission
(pregnant woman to fetus)
SIGNS AND SYMPTOMS
Mild fever
Swollen, tender lymph nodes, usually in the back of the neck or behind the ears
Rash beginning on the face and spreading downward, often clearing on the face as it
spreads
Rash appearing as pink or light red spots, which may merge to form evenly colored
patches
Itchy rash lasting up to 3 days, with affected skin shedding in fine flakes as it clears
Common in teens and adults: headache, loss of appetite, mild conjunctivitis, a stuffy or
runny nose, swollen lymph nodes in other parts of the body, and pain and swollen joints
LABORATORY DIAGNOSIS
IgM antibodies indicate recent or current rubella infection,
while IgG antibodies suggest past infection or immunity.
Confirmation of rubella infection is done through a real-time
RT-PCR test, crucial for distinguishing it from other viral rashes.
For confirmed rubella cases in pregnant women, further tests
like amniocentesis may be recommended to check for fetal
transmission.
TREATMENT
Rubella generally resolves without specific medication and can
be managed at home with over-the-counter drugs such as
acetaminophen (paracetamol) or cough and cold medicines.
Treatment for congenital rubella syndrome varies in
effectiveness, with some conditions treatable with medication
or surgery and others requiring ongoing management.
Prevention and Control
Wash your hands frequently,
especially if you’re sick.
The best way to prevent rubella is
Don’t share personal items — like
vaccination with the MMR vaccine.
cups or utensils — with anyone else.
It’s about 97% effective at
preventing rubella infection. That
Cover your mouth and nose when
means that out of 100 fully
sneezing or coughing.
vaccinated people, three or fewer
will get rubella. If traveling, know if rubella or other
infectious diseases are more
common at your destination.
NURSING INTERVENTIONS
Patients must be isolated to prevent community transmission; stress immediate
isolation upon early symptoms.
Measles causes severe itching; interventions include keeping nails short, wearing
long clothing, using recommended lotions, and avoiding sunlight/heat.
Treat conjunctivitis with warm saline, discourage eye rubbing, and protect eyes
from bright light.
Encourage oral hydration and consider oral rehydration solution.
Administer antipyretics as directed for a temperature over 38 Celsius, unless
otherwise instructed by a healthcare provider
GALLERY
