GERMAN MEASLES

GERMAN MEASLES

Also called as three-day measles/rubella From Latin meaning "little red"

Discovered in 18th century - thought to be variant of measles

First described as distinct clinical entity in German literature

Congenital rubella syndrome (CRS) described by Gregg in 1941

ETIOLOGY

Causative agent: Rubella virus Rna Virus of the

Togaviridae Family genus Rubivirus

Spherical in shape Highly sensitive to

heat, extremes of pH At 4°C, virus is

relatively stable for 24 hours

EPIDEMIOLOGY

Occurs worldwide The virus tends to peak in countries with

temperate climates Common in children ages 5-10 years old Human are only known reservoir

MODE OF TRANSMISSION

Airborne droplet emission Infected person coughs or sneezes

Acquired during pregnancy (1st Trimester) Virus can enter via the Placenta (Congenital

Rubella Syndrome)

INCUBATION PERIOD

between 14-21 days

PATHOGENESIS

Rubella VirusDeveloped in the nasopharynx

Respiratory Tract Skin

Lymph Nodes Joints

Placenta or

Fetus• Cough• Minor

sore throat

• Rashes

• Lesions • Lymphadenoph

aty

•Mild arthralgia• arthritis

• Placentitis• Fetal Damage

PATHOPHYSIOLOGY

Rubella virus

Transmitted via

respiratory droplets

Infects cells in the upper respiratory

tract

Virus multipli

es

Extends in the regional lymph nodes

Virus replicates in the nasopahrnxInfection is

established in the skin and other tissues including the respiratory tract

Forscheimer’s Spot may develop

Rashes develops, cough etc.

Virus can be

found in the skin,

blood and

respiratory tract

PATHOPHYSIOLOGY

Diagnosis: doctor suspects whether patient has measles

Virus culture/

blood test

Recent infection

With german measles vaccine

Vaccination and proper

interventions

German Measles left untreated, it may

cause complications: Rubella Arthritis,

Encephalitis, Purpura bronchitis, abscesses

in the ears and pneumonia

SIGNS AND SYMPTOMS

Aching joints Enlarged lymph

nodes Headache skin rashes that

consists of small rounded spots

Fatigue

Inflamed red eyes Runny nose Cough Sore throat

PATHOGNOMONIC SIGN

Forscheimer’s Spot

enanthem seen as small, red

spots (petechiae) in 20% of patients

similar spots can be seen in measles and scarlet fever 

CONGENITAL RUBELLA SYNDROME

Occurs during the first trimester of pregnancy Affects the development of the fetus may lead to several birth defects Infection may affect all organs May lead to fetal death or premature

delivery Severity of damage to fetus depends AOG. Infants: virus is isolated from urine and

feces

MANIFESTATION OF CONGENITAL RUBELLA

Eye defects Cataracts, glaucoma

Deafness Cardiac defects

Patent ductus arteriosus..

Bone lesions Psychiatric disoreder Central Nervous

system

Retardation, microcephaly

NURSING INTERVENTION

Isolation and quarantine Increase fluid intake Encourage the patient to rest Good ventilation Encourage the patient to drink either

lemon or orange juice Provide health teaching about Rubella

(cause, immunizations)

MEDICAL TREATMENT

There are no current treatments that can shorten the course of German measles infection.

PREVENTION

Mumps-Rubella Immunization (MMR)

Children 12 and 15 months and again between 3-6 years of age