Introduction

Rubella, also known as German measles, is a viral infection caused by the togavirus. Following the introduction of the MMR vaccine, it is now very rare (typically less than 5 cases in the UK per year). If contracted during pregnancy there is a risk of congenital rubella syndrome

Epidemiology

  • Incidence: 0.01 cases per 100,000 person-years
  • Peak incidence: 1-5 years
  • Sex ratio: 1:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Pathophysiology

Basics
  • outbreaks more common around winter and spring
  • the incubation period is 14-21 days
  • individuals are infectious from 7 days before symptoms appear to 4 days after the onset of the rash

Clinical features

Features
  • prodrome, e.g. low-grade fever
  • rash: maculopapular, initially on the face before spreading to the whole body, usually fades by the 3-5 day
  • lymphadenopathy: suboccipital and postauricular

Complications

Complications
  • arthritis
  • thrombocytopaenia
  • encephalitis
  • myocarditis