Rubella virus antenatal infection


A rare disorder caused by exposure of the fetus to maternal rubella and resulting in a range of abnormalities and fetal death is also possible.


* Growth deficiency * Mental deficiency * Small head * Deafness * Cataract * Glaucoma * Corneal opacity * Chorioretinitis * Small eye * Strabismus * Patent ductus arteriosus * Peripheral pulmonic stenosis * Fibromuscular proliferation * Thickened intima of medium arteries * Thickened intima of larger arteries * Septal defects * Myocardial disease * Thrombocytopenia *during infancy * Anemia *during infancy * Enlarged liver and spleen *during infancy * Obstructive jaundice *during infancy * Osteolytic metaphyseal lesions *during infancy * Interstitial pneumonia *during infancy


The rubella virus is transmitted through contact with the blood, urine, stools, or nasopharyngeal secretions of infected people and, possibly, by contact with contaminated articles of clothing. Transplacental transmission, especially in the first trimes-ter of pregnancy, can cause serious birth defects, such as microcephaly, mental retardation, patent ductus arteriosus, glaucoma, and bone defects. (See Congenital rubella syndrome.) Humans are the only known hosts for the rubella virus. The disease is contagious from about 10 days before the rash appears until 5 days after it has appeared.


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Treatment consists of aspirin for fever and joint pain. Bed rest isn’t necessary, but the patient should be isolated until the rash disappears. Immunization with live virus vaccine RA27/3, the only rubella vaccine available in the United States, is necessary for prevention and appears to be more immunogenic than previous vaccines. The rubella vaccine should be given with measles and mumps vaccines at age 15 months to decrease the cost and number of injections.