Abnormal Development - Rubella Virus

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Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.

Introduction

Child with Measles back rash day 3
Child with Measles back rash day 3 (CDC)
Rubella Virus EM
Rubella Virus, transmission electron micrograph (Image: CDC USA)

Rubella virus (Latin, rubella = little red), also known as "German Measles" (due to early citation in German medical literature), infection during pregnancy can cause congenital rubella syndrome (CRS) with serious malformations of the developing fetus. The type and degree of abnormality relates to the time of maternal infection.


Rubella peaked in 1964 and 1965, when 12.5 million cases were reported (USA). As a result, 20,000 babies were born with birth defects, 6,200 babies were stillborn, and an estimated 5,000 births were aborted, both naturally and assisted. At that time no treatment by vaccination existed and this only became available in 1969. The disease was dangerous because in children it was almost unnoticable and pregnant women often did not know that they had been exposed. Initial vaccination strategies varied between countries, in the United States infants were first to be vaccinated, while in the United Kingdom adolescent girls were first to be vaccinated.


Pregnancy effects of measles results in a higher risk of premature labor, spontaneous abortion, low-birth-weight, and possibly rare cases of birth defects with no definable pattern of malformation.[1]


Children infected with rubella before birth (a condition known as congenital rubella) are at risk for the following: growth retardation; malformations of the heart, eyes, or brain; deafness; and liver, spleen, and bone marrow problems.

The complete genomic sequence of Rubella is now known.[2] Rubella is a 9755 bp single stranded RNA positive-strand virus with no DNA stage (Togaviridae; Rubivirus) encoding nonstructural protein, capsid protein, glycoproteins E1 and E2. (More? Rubella Genome)


ICD-11 KA72.8 Congenital rubella syndrome.


Tinycc Rubella Virus page - http://tiny.cc/Rubella_Virus


Viral Links: viral infection | TORCH | cytomegalovirus | Hepatitis Virus | HIV | Parvovirus | Polio Virus | rubella virus | Chickenpox | Lymphocytic Choriomeningitis Virus | Zika Virus | rotavirus | vaccination | Environmental
Historic Embryology - Viral 
1941 Rubella Cataracts | 1944 Rubella Defects
Category:Rubella
WHO Rubella control map 2000-2016
Rubella control map (2000-2016)[3]
File:USA Measles cases and outbreaks graph
USA Measles cases and outbreaks graph

Some Recent Findings

  • Progress in Rubella and Congenital Rubella Syndrome Control and Elimination - Worldwide, 2000-2016[3] "Abstract Although rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or infants with a constellation of congenital malformations known as congenital rubella syndrome (CRS) (1). Rubella is a leading vaccine-preventable cause of birth defects. Preventing these adverse pregnancy outcomes is the focus of rubella vaccination programs. In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy for introduction of rubella-containing vaccine (RCV) into national immunization schedules and recommended an initial vaccination campaign, usually targeting children aged 9 months-14 years (1). The Global Vaccine Action Plan 2011-2020 (GVAP), endorsed by the World Health Assembly in 2012, includes goals to eliminate rubella in at least five of the six WHO regions by 2020 (2). This report updates a previous report (3) and summarizes global progress toward rubella and CRS control and elimination from 2000 to 2016. As of December 2016, 152 (78%) of 194 countries had introduced RCV into the national immunization schedule, representing an increase of 53 countries since 2000, including 20 countries that introduced RCV after 2012."
  • Rubella Seropositivity in Pregnant Women After Vaccination Campaign in Brazil's Federal District[4] "Rubella is an acute viral disease that usually does not generate sequels; however, in pregnant women the infection can cause serious abnormalities to fetuses, which are collectively called congenital rubella syndrome. In Brazil, population immunization was started in 1992, but few epidemiological studies have been conducted to assess vaccination coverage and seroconversion since then. The aim of this work is to evaluate the seropositivity of pregnant women to rubella virus after vaccination campaign was carried out in 2008. Serological tests for rubella diagnosis were performed in 87 pregnant women who attended the University of Brasilia Hospital, Federal District, Brazil. Antirubella IgG antibodies were detected in 83 out of 87 pregnant women (95.4%), with an age-independent seroprevalence. Only one woman was positive in IgM serological tests."
  • Americas region is declared the world’s first to eliminate rubella 29 April 2015 (PAHO/WHO) "The Americas region has become the first in the world to be declared free of endemic transmission of rubella, a contagious viral disease that can cause multiple birth defects as well as fetal death when contracted by women during pregnancy. Before mass-scale rubella vaccination, an estimated 16,000 to more than 20,000 children were born with CRS each year in Latin America and the Caribbean, while more than 158,000 rubella cases were reported in 1997 alone. In the United States, 20,000 infants were born with CRS during the last major rubella outbreak (1964-65)." PAHO
  • Rubella[5] "Rubella remains an important pathogen worldwide, with roughly 100 000 cases of congenital rubella syndrome estimated to occur every year. Rubella-containing vaccine is highly effective and safe and, as a result, endemic rubella transmission has been interrupted in the Americas since 2009. Incomplete rubella vaccination programmes result in continued disease transmission, as evidenced by recent large outbreaks in Japan and elsewhere. In this Seminar, we provide present results regarding rubella control, elimination, and eradication policies, and a brief review of new laboratory diagnostics. Additionally, we provide novel information about rubella-containing vaccine immunogenetics and review the emerging evidence of interindividual variability in humoral and cell-mediated innate and adaptive immune responses to rubella-containing vaccine and their association with haplotypes and single-nucleotide polymorphisms across the human genome."
More recent papers  
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Search term: Abnormal Development Rubella Virus

Elina Marjukka Seppälä, Noemí López-Perea, María de Viarce Torres de Mier, Juan E Echevarría, Aurora Fernández-García, Josefa Masa-Calles Last cases of rubella and congenital rubella syndrome in Spain, 1997-2016: The success of a vaccination program. Vaccine: 2018; PubMed 30454948

Joanna Bogusz, Iwona Paradowska-Stankiewicz Rubella in Poland in 2016 Przegl Epidemiol: 2018, 72(3);275-280 PubMed 30394039

Manoj Murhekar, Ashish Bavdekar, Asha Benakappa, Sridhar Santhanam, Kuldeep Singh, Sanjay Verma, Gajanan N Sapkal, Nivedita Gupta, Valsan Philip Verghese, Rajlakshmi Viswanathan, Asha Mary Abraham, Shyama Choudhary, Gururajrao N Deshpande, Suji George, Garima Goyal, Parul Chawla Gupta, Ishani Jhamb, Deepa John, Swetha Philip, Sandeep Kadam, Ravinder Kaur Sachdeva, Praveen Kumar, Anjali Lepcha, S Mahantesh, S Manasa, Urvashi Nehra, Sanjay Kumar Munjal, Vijaya Lakshmi Nag, Sadanand Naik, Naga Raj, Jagat Ram, R K Ratho, C G Raut, Manoj Kumar Rohit, R Sabarinathan, Sanjay Shah, Pratibha Singh, Mini P Singh, Ashish Tiwari, Neelam Vaid Sentinel Surveillance for Congenital Rubella Syndrome - India, 2016-2017. MMWR Morb. Mortal. Wkly. Rep.: 2018, 67(36);1012-1016 PubMed 30212443

Andres Moreira-Soto, Renata Cabral, Celia Pedroso, Monika Eschbach-Bludau, Alexandra Rockstroh, Ludy Alexandra Vargas, Ignacio Postigo-Hidalgo, Estela Luz, Gilmara Souza Sampaio, Christian Drosten, Eduardo Martins Netto, Thomas Jaenisch, Sebastian Ulbert, Manoel Sarno, Carlos Brites, Jan Felix Drexler Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil. mSphere: 2018, 3(4); PubMed 30089647

Ana Laura Tellechea, Victoria Luppo, María Alejandra Morales, Boris Groisman, Agustin Baricalla, Cintia Fabbri, Anabel Sinchi, Alicia Alonso, Cecilia Gonzalez, Bibiana Ledesma, Patricia Masi, María Silva, Adriana Israilev, Marcela Rocha, Marcela Quaglia, María Paz Bidondo, Rosa Liascovich, Pablo Barbero, RENAC Task Force Surveillance of microcephaly and selected brain anomalies in Argentina: Relationship with Zika virus and other congenital infections. Birth Defects Res: 2018; PubMed 29921033


Search term: Congenital Rubella Syndrome

Isabelle Boucoiran, Eliana Castillo ##Title## J Obstet Gynaecol Can: 2018, 40(12);1657-1668 PubMed 30527074

Isabelle Boucoiran, Eliana Castillo No. 368-RUBELLA IN PREGNANCY. J Obstet Gynaecol Can: 2018, 40(12);1646-1656 PubMed 30527073

Michiko Toizumi, Hien Minh Vo, Duc Anh Dang, Hiroyuki Moriuchi, Lay-Myint Yoshida Clinical manifestations of congenital rubella syndrome: A review of our experience in Vietnam. Vaccine: 2019, 37(1);202-209 PubMed 30503658

Elina Marjukka Seppälä, Noemí López-Perea, María de Viarce Torres de Mier, Juan E Echevarría, Aurora Fernández-García, Josefa Masa-Calles Last cases of rubella and congenital rubella syndrome in Spain, 1997-2016: The success of a vaccination program. Vaccine: 2018; PubMed 30454948

Neha Midha, Talvir Sidhu, Neha Chaturvedi, Renu Sinha, Dilip R Shende, Tanuj Dada, Viney Gupta, Ramanjit Sihota Systemic Associations of Childhood Glaucoma: A Review. J Pediatr Ophthalmol Strabismus: 2018, 55(6);397-402 PubMed 30452766

Older papers  
  • Rubella and congenital rubella syndrome control and elimination - global progress, 2000-2012[6] "Rubella virus usually causes a mild fever and rash in children and adults. However, infection during pregnancy, especially during the first trimester, can result in miscarriage, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy for introduction of rubella-containing vaccine (RCV) into national routine immunization schedules with an initial wide-age-range vaccination campaign that includes children aged 9 months-15 years. WHO also urged all member states to take the opportunity offered by accelerated measles control and elimination activities as a platform to introduce RCVs. The Global Measles and Rubella Strategic Plan (2012-2020) published by the Measles Rubella Initiative partners in 2012 and the Global Vaccine Action Plan endorsed by the World Health Assembly in 2012 include milestones to eliminate rubella and CRS in two WHO regions by 2015, and eliminate rubella in five WHO regions by 2020. This report summarizes the global progress of rubella and CRS control and elimination during 2000-2012. As of December 2012, a total of 132 (68%) WHO member states had introduced RCV, a 33% increase from 99 member states in 2000. A total of 94,030 rubella cases were reported to WHO in 2012 from 174 member states, an 86% decrease from the 670,894 cases reported in 2000 from 102 member states."
  • Results of the rubella elimination program in Catalonia (Spain), 2002-2011[7] "Rubella is usually a mild disease with nonspecific symptoms, but can cause congenital rubella syndrome (CRS) when infection occurs during pregnancy. The objective of this study was to evaluate the sensitivity and positive predictive value of different data sources used for surveillance purposes in the Rubella Elimination Program of Catalonia between 2002 and 2011. The Urgent Notification to the Statutory Disease Reporting System, the Individualized Disease Reporting System, screening for other viruses included in the Measles Elimination Program, the Microbiological Reporting System and the Minimum Hospital Discharge Data were evaluated. 100 suspected cases of postnatal rubella and 6 suspected cases of CRS were detected. ... Most confirmed postnatal cases (25 cases, 48.1%) were in the 25-44 y age group followed by the 15-24 y age group (11 cases, 21.2%)."
  • Controlling rubella and preventing congenital rubella syndrome – global progress, 2009 [8] "In 2009, a total of 121,344 rubella cases were reported to WHO from 167 countries, a 82% decrease from 2000"
  • An update on cardiovascular malformations in congenital rubella syndrome (CRS)[9] "We searched the English literature from 1941 through 2008 to identify studies that used cardiac catheterization or echocardiography to evaluate the cardiovascular malformations in CRS. Although published studies of CVMs in CRS have in general reported patent ductus arteriosus (PDA) as the CVM phenotype most commonly associated with CRS, among CRS cases evaluated by catheterization, branch pulmonary artery stenosis was actually more common than PDA. Moreover, although the combination of branch pulmonary artery stenosis and PDA was more common than either branch pulmonary artery stenosis or PDA alone, isolated branch pulmonary artery stenosis was twice as common as isolated PDA. ...Among children with suspected CRS, clinical evaluations for the presence of cardiovascular malformations should include examinations for both branch pulmonary artery stenosis and PDA."

Virus Structure

Identical genotype B3 sequences from measles patients in 4 countries
Identical genotype B3 sequences from measles patients in 4 countries, 2005.[10]

Lineage: Viruses; ssRNA viruses; ssRNA negative-strand viruses; Mononegavirales; Paramyxoviridae; Paramyxovirinae; Morbillivirus; Measles virus


  • ssRNA; linear; Length: 15,894 nt Measles virus, complete genome
  • virus replication involves a viral RNA-dependent RNA polymerase (vRdRp), using as a template a nucleocapsid (NC) made of a single strand of RNA in tight complex with the nucleoprotein (N).[11]
  • negative-strand genome contains six transcription units encoding the N, phospho (P), matrix (M), fusion (F), hemagglutinin (H), and large (L) or polymerase protein.
  • each N protein binds to 6 nucleotides.
  • the N polymer entirely covers the 15,894-nucleotide genome.
  • 23 known measles genotypes.
Rubella virus 01.jpg Rubella virus 03.jpg
This transmission electron micrograph (TEM) shows the presence of Rubella virus virions, as they were in the process of budding from the host cell surface to be freed into the host’s system. Inside the capsid lies the Rubella virus’ positive-sense single-stranded RNA ((+)ssRNA) genome. (Image: CDC) The spherical virions' icosahedral capsid is enclosed in the host cell membrane, budding and producing an enveloped virus particle. (Image: CDC)

Model of cell virus RNA accumulation

The following 5 -step model has been described for cell virus accumulation following hours post-infection (hpi)[11]

  1. 0 to ~5 hpi - incoming viral RNA-dependent RNA polymerase (vRdRp) initiated primary transcription from every gene with no detectable lag phase.
  2. ~5 to ~12 hpi - mRNA accumulates exponentially.
  3. ~12 to ~24 hpi - mRNAs, genomes, and antigenomes accumulate exponentially because of the increase of both newly available template and vRdRp.
  4. ~24 to ~30 hpi - genomes and antigenomes continue to accumulate exponentially at the same rate, whereas the accumulation of the transcripts slows down.
  5. 30+ hpi - genome and antigenome accumulation slows down, and the cell content in viral transcripts tends to decrease.


Vaccination

Rubella and measles elimination in the Americas
Rubella and measles elimination in the Americas

Japan - first introduced to Japan in 1966 and adopted in the national regular immunization program from 1978.

WHO Rubella Information

PAHO Countries reporting measles and rubella (2013-2014)
  • Causative agent - Virus
  • Reservoir - Humans
  • Spread - Close respiratory contact and aerosolized droplets
  • Transmission period - A few days before to seven days after rash; up to one year of age in congenitally infected
  • Subclinical infection - Common
  • Duration of natural immunity - Lifelong
  • Risk factors for infection (for unvaccinated individuals) - Highly transmissible; crowding; low socioeconomic status
  • Case-fatality rate - Less than 0.1 percent (dependent on care)
  • Vaccine (number of doses); route - Rubella (one or two); subcutaneous
  • Vaccine efficacy - 95 percent (at 12 months and up)
  • Duration of immunity after primary series - Lifelong in most; presumed rare cases of waning immunity after one dose, not two
  • Schedule - First dose at 12 to 15 months; when given, a second dose with measles vaccine
  • Status as of the end of 2001 - 110 countries in 2003
  • Comments - Lower efficacy when maternal antibody present

The World Health Organization recommends that the combination measles-rubella or measles-mumps-rubella vaccines be introduced only after careful evaluation of public health priorities within each country and following the establishment of an adequate program for measles control as demonstrated by high coverage rates as part of a well-functioning childhood immunization program.

Sources: WHO 2002, 2004.

Rubella History

Norman Gregg (1892-1966)

1941

Norman Gregg (1892-1966) was a Sydney ophthalmologist who in 1941[12] identified the link between maternal rubella infection and developmental abnormalities (atypical congenital cataracts, congenital heart defects, infants small-for-gestational age) initially in his own practice. This had coincided with a rubella epidemic that occurred between 1940 to 1941.


An example of the types of congenital defects following first trimester infection was also described later by Swan (1944).[13]

Links: Norman Gregg

1962

The rubella virus was initially isolated [14][15]

1969

United States first licensed live, attenuated rubella vaccines introduced.


USA rubella and congenital rubella syndrome cases.jpg

United States Elimination of rubella and congenital rubella syndrome, 1969-2004[16]

  1. 1969 - First official recommendations are published for the use of rubella vaccine. Vaccination is recommended for children aged 1 year to puberty.
  2. 1978 - Recommendations for vaccination are expanded to include adolescents and certain adults, particularly females.
  3. 1981 - Recommendations place increased emphasis on vaccination of susceptible persons in training and educational settings.
  4. 1984 - Recommendations are published for vaccination of workers in daycare centres, schools, colleges, companies, government offices, and industrial sites. Providers encouraged to conduct prenatal testing and postpartum vaccination of susceptible women. Recommendations for vaccination are expanded to include susceptible persons who travel abroad.
  5. 1990 - Recommendations include implementation of a new 2-dose schedule for measles-mumps-rubella vaccine.

Rubella and measles elimination in the Americas.jpg

Rubella and measles elimination in the Americas[17]

2014

In 2014 a Philippines measles outbreak of over 50,000 cases occurred. Travellers to and from the Philippines during this period led to an increase in cases occurring in other countries. For example, the USA experienced the highest number of measles cases CDC had reported in 20 years, over 600, many of the people who got measles last year were linked to travelers who had gotten measles from the Philippines.


Links: CDC 2014 travel advisory | NSW Health

2015

USA Measles cases and outbreaks graph 01.jpg

From January 1 to January 28, 2015, 84 people from 14 states were reported to have measles. Most of these cases are part of a large, ongoing outbreak linked to an amusement park in California. On January 23, 2015, CDC issued a Health Advisory to notify public health departments and healthcare facilities about this multi-state outbreak and to provide guidance for healthcare providers nationwide. For more information see CDC Press Briefing Transcript: Measles in the United States, 2015, January 29, 2015.

Congenital Rubella Syndrome

The following are some examples of developmental abnormalities associated with Congenital Rubella Syndrome (CRS).

ICD-11 Beta - KA72.8 Congenital rubella syndrome 
Description

A disease caused by an infection with the rubella virus in utero. This disease presents with symptoms depending on the timing of infection of the fetus and may present with birth defects (such as hearing loss), or intrauterine growth retardation. Transmission is by vertical transmission. Confirmation is by identification of rubella virus or detection of anti-rubella virus IgM antibodies in the neonate or infant.

Additional Information

Congenital rubella syndrome (CRS) is a group of anomalies that an infant may present as a result of maternal infection and subsequent foetal infection with rubella virus. In France, the prevalence at birth of CRS has decreased markedly to less than 1 case per 100,000 live births in 2002. The main defects caused by congenital rubella infection are sensorineural deafness (alteration of brainstem auditory evoked potentials) that may progress after birth, eye defects (such as cataract), cardiovascular defects, brain damage (occurring only after infection between the 3rd and 16th week of gestation) that may cause mild to severe intellectual deficit, microcephaly and spastic diplegia, and prematurity and low birth weight. Major structural malformations are rare. The prenatal diagnosis of foetal infection must be done in case of contact of the pregnant woman with an infected patient, with or without eruptive disease. If the woman was not vaccinated recently, a primary rubella infection is certain in case of:

  1. increased blood levels of IgG or seroconversion with IgM above the positivity threshold;
  2. low avidity of IgG;
  3. identification of IgM in foetal blood (foetal blood sampling can only be performed after 22 weeks of gestation);
  4. identification by gene amplification of the viral genome in the amniotic fluid;
  5. presence of specific IgM in the blood of the newborn or in any other sample from the foetus/newborn.

In case of positive prenatal diagnosis of primary infection, the full congenital rubella syndrome is common when maternal infection occurs during the first two months of pregnancy. Up to 12 weeks gestation, about 80% of exposed foetuses are affected, and between 12 and 16 weeks, about half of exposed foetuses are affected. During this latter period of gestation, deafness is the most common abnormality encountered; the other defects and growth impairments appear to occur only after exposure during the first trimester. Congenital anomalies and growth impairment are rare with infection after 16 weeks gestation.

ICD-10 : P35.0

ICD-10

Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.

Vision

Congenital rubella syndrome retinopathy
Congenital rubella syndrome retinopathy[18]
  • retinopathy
  • cataracts
  • micropthalmia
  • glaucoma
  • retinitis
Links: Vision Abnormalities | Vision Development

Hearing

  • sensorineural deafness
Links: Hearing Abnormalities | Hearing Development

Neural

  • mental retardation
  • meningoencephalitis
  • (rare) progressive rubella panencephalitis
  • microcephaly

Cardiovascular

  • patent ductus arteriosis
  • atrial septal defect
  • ventricular septal defect
  • peripheral pulmonic stenosis

Endocrine

  • insulin dependent diabetes mellitus
  • thyroiditis

Other Systems

  • general growth retardation
  • radiolucent bone disease
  • heptosplenomegaly
  • heamatologic abnormalities (thrombocytopenia, purpura)
  • pneumonitis

References

  1. Chiba ME, Saito M, Suzuki N, Honda Y & Yaegashi N. (2003). Measles infection in pregnancy. J. Infect. , 47, 40-4. PMID: 12850161
  2. Dominguez G, Wang CY & Frey TK. (1990). Sequence of the genome RNA of rubella virus: evidence for genetic rearrangement during togavirus evolution. Virology , 177, 225-38. PMID: 2353453
  3. 3.0 3.1 Grant GB, Reef SE, Patel M, Knapp JK & Dabbagh A. (2017). Progress in Rubella and Congenital Rubella Syndrome Control and Elimination - Worldwide, 2000-2016. MMWR Morb. Mortal. Wkly. Rep. , 66, 1256-1260. PMID: 29145358 DOI.
  4. Nóbrega YKM, de Carvalho BC, Nitz N, Vital TE, Leite FB, Sequeira IJ, Moreira EE, de Andrade JKB, Gandolfi L, Pratesi R & Hecht MM. (2017). Rubella Seropositivity in Pregnant Women After Vaccination Campaign in Brazil's Federal District. Viral Immunol. , 30, 675-677. PMID: 28972455 DOI.
  5. Lambert N, Strebel P, Orenstein W, Icenogle J & Poland GA. (2015). Rubella. Lancet , 385, 2297-307. PMID: 25576992 DOI.
  6. Centers for Disease Control and Prevention (CDC). (2013). Rubella and congenital rubella syndrome control and elimination - global progress, 2000-2012. MMWR Morb. Mortal. Wkly. Rep. , 62, 983-6. PMID: 24304830
  7. Barrabeig I, Torner N, Martínez A, Carmona G, Ciruela P, Batalla J, Costa J, Hernández S, Salleras L & Domínguez A. (2013). Results of the rubella elimination program in Catalonia (Spain), 2002-2011. Hum Vaccin Immunother , 9, 642-8. PMID: 23299566
  8. No authors listed Controlling rubella and preventing congenital rubella syndrome – global progress, 2009 Wkly Epidemiol Rec. 2010 Oct 15;85(42):413-8. PMID20949700 | PDF
  9. Oster ME, Riehle-Colarusso T & Correa A. (2010). An update on cardiovascular malformations in congenital rubella syndrome. Birth Defects Res. Part A Clin. Mol. Teratol. , 88, 1-8. PMID: 19697432 DOI.
  10. Rota J, Lowe L, Rota P, Bellini W, Redd S, Dayan G, van Binnendijk R, Hahné S, Tipples G, Macey J, Espinoza R, Posey D, Plummer A, Bateman J, Gudiño J, Cruz-Ramirez E, Lopez-Martinez I, Anaya-Lopez L, Holy Akwar T, Giffin S, Carrión V, de Filippis AM, Vicari A, Tan C, Wolf B, Wytovich K, Borus P, Mbugua F, Chege P, Kombich J, Akoua-Koffi C, Smit S, Bukenya H, Bwogi J, Baliraine FN, Kremer J, Muller C & Santibanez S. (2006). Identical genotype B3 sequences from measles patients in 4 countries, 2005. Emerging Infect. Dis. , 12, 1779-81. PMID: 17283637 DOI.
  11. 11.0 11.1 Plumet S, Duprex WP & Gerlier D. (2005). Dynamics of viral RNA synthesis during measles virus infection. J. Virol. , 79, 6900-8. PMID: 15890929 DOI.
  12. Gregg NM. Congenital cataract following German measles in the mother. (1941) Trans Ophthalmol Soc Aust. 3: 35–46. PubMed 1879476
  13. Swan C. A study of three infants dying from congenital defects following maternal rubella in the early stages of pregnancy. (1944) J. Pathol. Bact. 41(3): 289-295.
  14. PARKMAN PD, BUESCHER EL & ARTENSTEIN MS. (1962). Recovery of rubella virus from army recruits. Proc. Soc. Exp. Biol. Med. , 111, 225-30. PMID: 13941530
  15. WELLER TH, ALFORD CA & NEVA FA. (1964). RETROSPECTIVE DIAGNOSIS BY SEROLOGIC MEANS OF CONGENITALLY ACQUIRED RUBELLA INFECTIONS. N. Engl. J. Med. , 270, 1039-41. PMID: 14122801 DOI.
  16. Centers for Disease Control and Prevention (CDC). (2005). Elimination of rubella and congenital rubella syndrome--United States, 1969-2004. MMWR Morb. Mortal. Wkly. Rep. , 54, 279-82. PMID: 15788995
  17. Progress Report: Elimination of Rubella and CRS in the Americas, 2007 Powerpoint slide on Elimination of Rubella and Congenital Rubella Syndrome in the Americas: Progress Report. Pan American Health Organization World Health Organization.
  18. Jivraj I, Rudnisky CJ, Tambe E, Tipple G & Tennant MT. (2014). Identification of ocular and auditory manifestations of congenital rubella syndrome in mbingo. Int J Telemed Appl , 2014, 981312. PMID: 25525427 DOI.

Textbooks

Reviews

De Santis M, Cavaliere AF, Straface G & Caruso A. (2006). Rubella infection in pregnancy. Reprod. Toxicol. , 21, 390-8. PMID: 16580940 DOI.

Terada K. (2003). Rubella and congenital rubella syndrome in Japan: epidemiological problems. Jpn. J. Infect. Dis. , 56, 81-7. PMID: 12944671

Articles

Feng Y, Santibanez S, Appleton H, Lu Y & Jin L. (2011). Application of new assays for rapid confirmation and genotyping of isolates of rubella virus. J. Med. Virol. , 83, 170-7. PMID: 21108356 DOI.

Tipples G & Hiebert J. (2011). Detection of measles, mumps, and rubella viruses. Methods Mol. Biol. , 665, 183-93. PMID: 21116802 DOI.

Binnicker MJ, Jespersen DJ & Harring JA. (2010). Multiplex detection of IgM and IgG class antibodies to Toxoplasma gondii, rubella virus, and cytomegalovirus using a novel multiplex flow immunoassay. Clin. Vaccine Immunol. , 17, 1734-8. PMID: 20861325 DOI.

Fontana J, López-Iglesias C, Tzeng WP, Frey TK, Fernández JJ & Risco C. (2010). Three-dimensional structure of Rubella virus factories. Virology , 405, 579-91. PMID: 20655079 DOI.

Plotkin SA. (2006). The history of rubella and rubella vaccination leading to elimination. Clin. Infect. Dis. , 43 Suppl 3, S164-8. PMID: 16998777 DOI.

Search Pubmed

Search Pubmed: Rubella Virus | Congenital Rubella Syndrome | Congenital Rubella Infection



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Cite this page: Hill, M.A. (2018, December 15) Embryology Abnormal Development - Rubella Virus. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Rubella_Virus

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© Dr Mark Hill 2018, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G