RUBELLA
("German Measles")
Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
I. IDENTIFICATION
A. CLINICAL DESCRIPTION: An illness with all of the following characteristics: acute onset of generalized maculopapular rash; temperature of > 37.2 o C (> 99 o F), if measured; and arthralgia/arthritis, or lymphadenopathy, or conjunctivitis.
B. REPORTING CRITERIA: Clinical diagnosis.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- Isolation of rubella virus, OR
- Significant rise between acute and convalescent titers in serum titers in serum rubella IgG antibody level by any standard serologic assay, OR
- Positive serologic test for rubella IgM antibody.
D. WISCONSIN CASE DEFINITION: A case that is laboratory confirmed or that meets the clinical description and is epidemiologically linked to a laboratory confirmed case.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.
B. EPIDEMIOLOGY REPORTS REQUIRED:
- Acute and Communicable Diseases Case Report (DPH 4151).
- Rubella Surveillance Worksheet (CDC Rubella).
C. PREVENTION MEASURES:
- Routinely administer initial dose of MMR (measles, mumps and rubella) vaccine aT 12 - 15 months of age and second dose at school entry (4-6 years of age).
- Vaccine recommended for susceptible women of childbearing age and susceptible young adults who have contact with young children or congregate at institutions of higher education.
- Medical personnel likely to come into contact with persons with rubella or women of childbearing age should show proof of immunity to rubella.
- Wisconsin Administrative Code HSS 124.07 requires new hospital employees who have contact with rubella patients, pediatric patients or female patients of child bearing age to have documentation of rubella vaccine or immunity to rubella.
D. PUBLIC HEALTH INTERVENTIONS:
- Exclude children from school and adults from work for seven days after onset of rash.
- If infection occurs during pregnancy, the woman should be counseled by her obstetrician about the risks to her fetus and her options, including termination of the pregnancy.
- Urge immunization of all contacts (children and non-pregnant adults) that have not been previously immunized. However, immunization will not necessarily prevent a second generation of infection or illness. Passive immunization with IG is not indicated.
- Identify pregnant female contacts, especially those in the first trimester. Test such contacts serologically for susceptibility or early infection (IgM antibody) and advise accordingly.
III. CONTACTS FOR CONSULTATION
A. BCDP / IMMUNIZATION PROGRAM: (608) 266-3031.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH /
1. SEROLOGY: (608) 262-0248
2. CULTURE: (608) 262-3185IV. RELATED REFERENCES
1. "Rubella" DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
2. Heymann DL, ed. RIBELLA (German measles). Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:464-468.
3. Pickering LK, ed. Rubella. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:536-540.
4. Rubella Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1990; 39(No.RR-15): 1-18.
V. DISEASE TRENDS
There were no reported cases of rubella reported in Wisconsin between 1999 and 2003.