Clinical Features:

 

…        Prodrome ñ Incubation period 12-23 days

Ý In older children and adults, low grade fever, malaise, swollen

ÝÝÝÝ glands, upper respiratory infection (URI)

Ý Prodrome is rare in children

…        RashÝÝÝÝÝÝÝ -Ý First manifestation in children

Ý Begins on face, progresses from head to foot

Ý Persists about 3 days

Ý Faint, maculopapular (small spots), does not coalesce

Ý Occasionally pruritic (itch-causing)

…        Lymphadenopathy in second week

…        Conjunctivitis, testalgia, orchitis

** 30 ñ 50% of cases may be subclinical or inapparent

 

Complications:Ý Complications are uncommon, and tend to occur more often in adults

ÝÝ than in children

…        Arthritis ñÝ In up to 70% of adult women, rare in children or males

Occur at same time as rash, last up to 1 month

…        Thrombocytopenic purpura (loss of platelets in blood)ñ 1 in 3,000 cases

ÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝ More common in children

…        Encephalitis ñ 1 in 5,000 cases; mortality varies 0-50%

 

…        Congenital Rubella Syndrome (CRS)

…        Caused by a motherís being infected with rubella during pregnancy

…        Severity depends on time of gestation at which infection occurs:

ÝÝÝÝÝÝÝÝÝÝÝ 85% of infants infected in first trimester of pregnancy will be affected

ÝÝÝÝÝÝÝÝÝÝÝ Defects are rare when infection occurs after 20^th week of gestation

…        An array of congenital defects can result:

…        Deafness is most common manifestation

…        Eye defects ñ cataracts, glaucoma, retinopathy

…        Cardiac defects

…        Neurologic abnormalities ñ microencephaly, mental retardation

…        Bone lesions

…        Liver and spleen damage

…        Prevention of CRS is the main objective of rubella vaccination in the US