🦠 Deep Dive: Rubella (German Measles)
🎧 In this episode, we're tackling Rubella — a once widespread viral illness that's now rare in the UK thanks to vaccination. But its danger in pregnancy makes it essential knowledge for anyone revising for the MSRA or working in clinical practice.
👩⚕️👶 Key Learning Points
📌 Definition
• Rubella is a viral infection caused by the rubella virus
• Usually mild in children/adults, but devastating in pregnancy — can cause Congenital Rubella Syndrome (CRS)
• Notifiable disease in the UK ✅
📌 Transmission
• Spread via respiratory droplets 💨
• Also transmits vertically across the placenta → fetal damage
• Humans only host 🧬
• Most infectious 1 week before rash + 4 days after
📌 Mnemonic
Respirate → Tissue → Fetus → Harm
🗣️ Virus enters respiratory tract → 🩸 spreads to tissues → crosses placenta → 🧠 damages fetal organs
📌 Epidemiology
• Pre-MMR: Common in UK children
• Now: Rare in UK due to MMR 💉
• Globally: ~100,000 cases of CRS/year (WHO) 🌍
• Still occurs in unvaccinated individuals or via imported cases
📌 Symptoms
• Mild fever
• Lymphadenopathy (esp. posterior auricular, suboccipital)
• Maculopapular rash: starts on face, spreads downwards ⬇️
• Prodrome: lassitude, headache, conjunctivitis
• ± Forchheimer spots on soft palate (not specific)
• Adults may get arthralgia (esp. women)
📌 Mnemonic: FELLAR-GMLAP
F – Fever
E – Eyes (conjunctivitis)
L – Lassitude
L – Lymphadenopathy
A – Appetite loss
R – Rash (maculopapular)
GMLAP – Generalised Maculopapular LymphAdenopathy Posterior
📌 Differentials
• Measles, Parvovirus B19, HHV-6, Scarlet fever, Kawasaki, Drug rash, Dengue, Zika
• Think travel 🧳 and vaccine history
📌 Diagnosis
• Clinical suspicion + confirm with:
Serology: IgM/IgG
PCR from throat, urine, blood
• FBC may show lymphocytosis or thrombocytopenia
📌 Management
• No antiviral treatment
• Supportive care: fluids, rest, paracetamol
• Avoid aspirin in kids (⚠️ Reye’s syndrome)
• Isolation: 5 days after rash onset
• Urgent referral if in pregnancy – risk of CRS
📌 Complications
• Congenital Rubella Syndrome (CRS): 🧠🧏👁️💔
Deafness
Cataracts
Congenital heart disease
Intellectual disability
• Others:
Encephalitis
Thrombocytopenia
Guillain-Barre, arthritis
📌 Prevention
• 💉 MMR vaccine is key
• Given routinely in UK in childhood
• Pregnant women screened for immunity
• If non-immune → vaccinate postnatally
📚 MSRA Rubella Resources
📝 Revision Notes:
https://www.passthemsra.com/topic/rubella-revision-notes/
🧠 Flashcards:
https://www.passthemsra.com/topic/rubella-flashcards/
💬 Accordion Q&A Notes:
https://www.passthemsra.com/topic/rubella-accordion-qa-notes/
🚀 Rapid Quiz:
https://www.passthemsra.com/topic/rubella-rapid-quiz/
🎓 Paediatrics Course:
https://www.passthemsra.com/courses/paediatrics-for-the-msra/
#MSRA #MSRARevision #MSRARubella #CongenitalRubellaSyndrome #MMRVaccine #RubellaPodcast #PaediatricsMSRA #GermanMeasles #MSRAFlashcards #MSRAQuiz #PassTheMSRA #FreeMSRA
