k-26 congenital rubella

7/24/2019 K-26 Congenital Rubella

1/15

CONGENITAL RUBELLACONGENITAL RUBELLA

SYNDROMESYNDROMEInfectious and Tropical Pediatric DivisionInfectious and Tropical Pediatric Division

Department of Child HealthDepartment of Child Health

Medical Faculty, University of Sumatera UtaraMedical Faculty, University of Sumatera Utara


2/15


3/15

History - RubellaHistory - Rubella

The Terato&enic property of theThe Terato&enic property of the

infection %as documented y aninfection %as documented y anustralian opthalmolo&ist "ree& inustralian opthalmolo&ist "ree& in

()-(()-(


4/15

RubellaRubella

( German Measles )( German Measles ) Ruella is alsoRuella is also

called as . daycalled as . day

Measles or "ermanMeasles or "erman

Measles$Measles$ Family /Family / TogaviridaeTogaviridae

"enus 0"enus 0 RubivirusRubivirus

In &eneral elon&In &eneral elon&to To&avirus &roupto To&avirus &roup


5/15

Rubella VirusRubella Virus

Ruella virus areRuella virus are

ss / R1 virusss / R1 virus

Diameter 2+ / *+ nmDiameter 2+ / *+ nm 3nveloped Spherical3nveloped Spherical

4irus carry4irus carry

hema&&lutininhema&&lutinin

4irus multiply in the4irus multiply in thecytoplasam of infectedcytoplasam of infected

cell$cell$


6/15

EpidemiologyEpidemiology

Ruella is %orld %ide in distriutionRuella is %orld %ide in distriution 5ccurs round the year,5ccurs round the year,

3pidemics occur every 6+ / 62 years3pidemics occur every 6+ / 62 years Infection is transmitted y respiratoryInfection is transmitted y respiratory

routeroute

The use of Ruella vaccine has no%The use of Ruella vaccine has no%eliminated oth epidemic and endemiceliminated oth epidemic and endemicRuella in US and several developedRuella in US and several developedcountriescountries


7/15

Treatment and PreventionTreatment and Prevention

Ruella is a mild self limited illness$Ruella is a mild self limited illness$

1o specific treatment or ntiviral1o specific treatment or ntiviral

treatment is indicated$treatment is indicated$

Ho%ever 7aoratory proved andHo%ever 7aoratory proved and

clinically missed Ruella in the Ist .0clinically missed Ruella in the Ist .0

- months of pre&nancy is associated- months of pre&nancy is associated

%ith fetal infections$%ith fetal infections$


8/15

Congenital Rubella SyndromeCongenital Rubella Syndrome

Maternal viremia %ith Ruella infectionMaternal viremia %ith Ruella infectiondurin& pre&nancy may result in infection ofdurin& pre&nancy may result in infection ofplacenta and fetus$placenta and fetus$

The &ro%th rate of fetal cells are reduced$The &ro%th rate of fetal cells are reduced$ Results in fe%er numer of cells after theResults in fe%er numer of cells after the

irth$irth$ 7ead to deran&ed and hypo plastic or&an7ead to deran&ed and hypo plastic or&an

development$development$ Results in structural dama&e andResults in structural dama&e and

anormalitiesanormalities


9/15

Rubella infecion ! variou"

ubella infecion ! variou"

ri#e"er"

ri#e"er"

IIststtrimester infections lead to anormalities in 82trimester infections lead to anormalities in 829 of cases$ and &reater dama&e to or&ans9 of cases$ and &reater dama&e to or&ans

66ndndtrimester infections lead to defects in (: 9trimester infections lead to defects in (: 9 ; 6+ %ee


10/15

Clinical FindingsClinical Findings

( Congenital Rubella Syndrome )( Congenital Rubella Syndrome )May e transient effects in infants$May e transient effects in infants$

Permanent manifestations may ePermanent manifestations may e

apparent at irth, ecome reco&ni>edapparent at irth, ecome reco&ni>ed

durin& the first year$durin& the first year$

Developmental anormalities appearDevelopmental anormalities appear

durin& childhood and adolescents$durin& childhood and adolescents$


11/15

Classical Triad of RubellaClassical Triad of Rubella

Classical TriadClassical Triad CataractCataract

CardiacCardiac

abnormalitiesabnormalities

DeafnessDeafness

Other manifestationsOther manifestations

Growth retardationGrowth retardation

RashRash

HepatosplenomegalyHepatosplenomegaly

JaundiceJaundice

MeingoencephalitisMeingoencephalitis

CNS defects lead toCNS defects lead tomoderate to profoundmoderate to profound

mental retardationmental retardation


12/15

ther !eurological manifestionsther !eurological manifestions

Prolems in alanceProlems in alance

Motor s


13/15

"iagnosis of"iagnosis of

Congenital Rubella SyndromeCongenital Rubella Syndrome

Demonstration ofDemonstration of

Ruella antiodiesRuella antiodies

of I&M in a ne%of I&M in a ne%orn is dia&nosticorn is dia&nostic

value$ s I&Mvalue$ s I&M

&roup donot cross&roup donot cross

the placenta andthe placenta andthey are produce inthey are produce in

the infected fetus,the infected fetus,


14/15

Trea#en$ %revenion$ ConrolTrea#en$ %revenion$ Conrol

1o specific treatment is1o specific treatment is

availaleavailale

CRS can be prevented byCRS can be prevented by

efective immunization oefective immunization o

the young children andthe young children andteenage girls, remain theteenage girls, remain the

best option to preventbest option to prevent

Congenital RubellaCongenital Rubella

Syndrome.Syndrome.

The component oThe component oRubella in MMR vaccineRubella in MMR vaccine

protects the vaccinatedprotects the vaccinated


15/15

##R $accine##R $accine

TheThe MMR vaccineMMR vaccineis a mi=ture of three liveis a mi=ture of three liveattenuated viruses, administered via in?ection forattenuated viruses, administered via in?ection forimmuni>ation a&ainst measles, mumps andimmuni>ation a&ainst measles, mumps andruella$ It is &enerally administered to childrenruella$ It is &enerally administered to children

around the a&e of one year, %ith a second dosearound the a&e of one year, %ith a second doseefore startin& school !i$e$ a&e -@2#$ The secondefore startin& school !i$e$ a&e -@2#$ The seconddose is not a oosterA it is a dose to producedose is not a oosterA it is a dose to produceimmunity in the small numer of persons !6029#immunity in the small numer of persons !6029#%ho fail to develop measles immunity after the%ho fail to develop measles immunity after the

first dose In the United States, the vaccine %asfirst dose In the United States, the vaccine %aslicensed in ():. and the second dose %aslicensed in ():. and the second dose %asintroduced in the mid ())+s$ It is %idely used inintroduced in the mid ())+s$ It is %idely used inall 1ational, Universal Immuni>ation pro&rammesall 1ational, Universal Immuni>ation pro&rammes

k-26 congenital rubella

Documents