Chapter 55 : Rubella Virus

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Rubella virus is the sole member of the genus of the family. The other genus in the family of is . In contrast to the alphaviruses, which replicate in arthropods and in vertebrates, rubella virus has no invertebrate hosts. As humans are the only known natural host for rubella virus, the virus must circulate continuously within populations of people between periods of epidemics. While direct cellular destruction by rubella virus accounts for some of the tissue damage seen in congenital rubella syndrome, vascular injury and resulting insufficiency are more important in the pathogenesis of congenital defects. The consequences of in utero rubella virus infection can be considered broadly as belonging to one of three categories: (i) signs and symptoms that are transiently apparent in affected infants, (ii) permanent manifestations that are noted within the first year of life, and (iii) manifestations of congenital rubella that are delayed in onset until later in life (2 years of age to adulthood). Rubella virus infection is definitively diagnosed by isolation of rubella virus in tissue culture, using one of several cell lines and primary cell strains. Viral interference in African green monkey kidney (AGMK) cells is one common culture technique by which the presence of rubella virus is demonstrated.

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55

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Rubella virus
Enzyme-Linked Immunosorbent Assay
Major Histocompatibility Complex
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Image of FIGURE 1

Number of reported cases of rubella and congenital rubella syndrome (CRS), by year, and chronology of rubella vaccination recommendations by the Advisory Committee on Immunization Practices, United States, 1966 to 2004. *, 1969—first official recommendations are published for the use of rubella vaccine. Vaccination is recommended for children aged 1 year to puberty. †, 1978—recommendations for vaccination are expanded to include adolescents and certain adults, particularly females. Vaccination is recommended for adolescent or adult females and males in populations in colleges, certain places of employment (e.g., hospitals), and military bases. §, 1981—recommendations place increased emphasis on vaccination of susceptible persons in training and educational settings (e.g., universities or colleges) and military settings and vaccination of workers in health care settings. ¶, 1984—recommendations are published for vaccination of workers in day care centers, schools, colleges, companies, government offices, and industrial sites. Providers are encouraged to conduct prenatal testing and postpartum vaccination of susceptible women. Recommendations for vaccination are expanded to include susceptible persons who travel abroad. **, 1990—recommendations include implementation of a new two-dose schedule for MMR vaccine. (Modified from reference .)

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55
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Image of FIGURE 2

Likelihood and outcome of congenital rubella syndrome as a function of time of acquisition of maternal rubella virus infection. Hatched bars, rate of fetal infection; striped bars, rate of defects in infected persons; diamonds, overall risk of defects after maternal infection. (Adapted from reference with permission.)

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55
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Image of FIGURE 3

Schematic of the immune response in acute rubella virus infection. Values on the axis indicate number of days. RIA, radioimmunoassay; EIA, enzyme immunoassay; HI, hemagglutination inhibition; LA, latex agglutination; FIA/FIAX and IFA, immunofluorescence; Nt, neutralization; PHA, passive agglutination. (Reprinted from reference with permission of Elsevier.)

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55
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Image of FIGURE 4

Schematic of the immune response in the mother, fetus, and infant after maternal and fetal rubella virus infections in the first trimester of pregnancy. (Reprinted from reference with permission of Elsevier.)

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55
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Image of FIGURE 5

(Left) Provisional zones of calcification are poorly defined and irregular. Radiolucent defects are present in metaphyses of femora and tibiae and the parallel long axis of the bone. (Right) Lower extremities 2 months later show nearly complete disappearance of osseous abnormalities. (Reprinted from reference with permission of the American Medical Association.)

Citation: Kimberlin D. 2009. Rubella Virus, p 1275-1289. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815981.ch55
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