K-26 Congenital Rubella
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Transcript of K-26 Congenital Rubella
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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
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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
()-(()-(
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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
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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$cell$
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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
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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$%ith fetal infections$
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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
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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
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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$durin& childhood and adolescents$
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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
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ther !eurological manifestionsther !eurological manifestions
Prolems in alanceProlems in alance
Motor s
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"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,
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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
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##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