Rubella
(German Measles)
Star Munoz
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What is Rubella?
What is Rubella?
Rubella virus is the only memeber of the genus Rubivirus in the family Togaviridae (13). Togaviridae are enveloped, positive strand RNA viruses (1). The genomic RNA is enclosed by an icosahedral nucleocapsid (12). Rubella is a spherical, 40-to 80 mm virus and has spike-like hemagglutinin surface projections (13). Rubella virus contains three major structural polypeptides: two membrane glycoproteins [E1: responsible for viral hemagglutination and neutralization and E2: glycosylation] and a single nonglycosylated RNA associated capsid protein within the virion (13).
Mode of Transmission
Mode of Transmission
Rubella is a viral infection, also known as German Measles. Rubella virus infects only vertebrate hosts, and humans are the only known natural reservoir (12). Rubella virus is transmitted via direct or droplet contact with respiratory secretions, such as when an infected person who coughs and sneezes (13). This virus can also congenitally transmitted transplacentally, if a pregnant women becomes infected. Contacting Rubella while pregnant is very dangerous for the baby and can cause risk for miscarriage, stillbirth, and severe birth defects (7). The most severe damage can be from early in pregnacy [12 weeks] (7). An infected indivdual can spread the disease to others up to one week before seeing signs and remain contagious up to a week after (7).
BasicMedical Key, https://basicmedicalkey.com/rubella-virus/
Entry and Exit
Entry and Exit
The virus enters the cells via receptor-mediated endocytosis. In the modified lysosome, the low pH uncoats the virus which makes it hydrophobic. The viral envelope fuses with the cellular membrane followed by release of genomic RNA into the cytoplasm. In the endoplasmic reticulum, synthesis of structual proteins takes place where the peptidase separates the polyprotein into indivdual structural proteins, and are transported to the golgi complex. The nucleocapsid assembly and binding occurr and Rubella virions undergo series of of maturation before exocytosis (11).
Detection and Diagnosed
Detection and Diagnosed
Rubella occurs worldwide with a seasonal distribution (13). Both adults and children have mild but noticeable symptoms such as: a red rash, fever, headache, pink eye, cough, sore throat, and runny nose (7). About 25 to 50% of people infected with Rubella will not experience any symptoms [asymptomatic] (7). Since Rubellas rash looks like common rash, it can be diagnosed with laboratory testing from a collection of urine or blood samples (6). These tests can detect of the presence of different types of Rubella antibodies in the blood and whether you've had a recent or past infection or Rubella vaccine (9).
Infection Progress
Infection Progress
Rubella virus infects permissive cells; first replicating in the upper respiratory tract and in the nasopharyngeal lymphoid tissue (11). Rubella infects lymphocytes, B-cells, and CD4+/ CD8+ T-cells (12). Neutralizing and hemagglutination-inhibiting antibodies and cell-mediated immunity develop promptly (13). Infection rapidly induces a specific immune response which provides lifelong protection against the natural disease (13). Reinfection can can occur however, are asymptomatic (13).
Molecular Pathway for Host Defense
Molecular Pathway for Host Defense
Rubella is an acute, contagious viral infection that occurs soon after contact with infection (4). Rubella virus is both in combination of cell mediated and antibody mediated. Clearance of measles virus occurs at the time of the rash, but may be incomplete in immunocompromised patients leading to progressive lung or nervous system infection (3). Clearance of measles virus RNA from lymphoid tissue is slow and associated with continuous maturation of antibody and T cell responses that lead to life long immunity to reinfection (3). Rubella is no longer endemic in the United States however, Rueblla remains a problem in other parts of the world (7).
Molecular Pathway for Disease
Molecular Pathway for Disease
Rubella is transmitted via direct or droplet contact from the infected, with humans being the only natural hosts (7). Infections usually occurs during late winter to early spring (7). When Rubella infects the indivduals body, it mostly affects the skin along with the lymph nodes. Rubella produces enzymes used for serology testing to confirm Rublla, these enzymes include IgG and IgM (7). Rubella virus has a small genome and codes five proteins, those of which interact with the hosts proteins that bring about teratogenic effects (2). Replication of the virus, directly and indirectly affects the expression of genes involved in the development of sensory organs (2).
How to Prevent?
How to Prevent?
To best protect yourself and your baby from getting Rubella, get the MMR vaccine (measles mumps and rubella). As a vaccine does not prevent you from getting sick or getting the virus it will prevent you from dying of the virus. For children the vaccine is separated into two doses, with the first dose starting at 12-15 months old and the second dose at 4-6 years old (7). Teens and adults should be up to date on their MMR vaccination (7). The MMR vaccine is safe and effefctive with a 97% effectiveness of preventing rubella (7).
Bpac better medicine, https://bpac.org.nz/2021/mmr.aspx
Centre for Health Protection, https://www.chp.gov.hk/en/features/101183.html
Treatment
Treatment
As a virus, Rubella has no known treatments but the symptoms itself can be treated. It is recommended to talk to a healthcare provider to best figure out the treatment. Rubella usually cause mild symptoms which are treated with best rest and acetaminophen to treat the fever (7). Asymptomatic indivduals can still spread the pathogen. If anything isolation from others for at least seven days or after the rash has dissappeared (9) can prevent the spread.
How we Study the Virus? (4)
How we Study the Virus? (4)
Because the virus particles have a lipid envelope, they are important models for studying the synthesis, posttranslational modification, and localization of membrane glycoprotein (1). Laboratory testing and procedures of Rubella include (7):
serology testing- Test both IgG and IgM. IgG serology testing is used for assessing Rubella immunity, can determine recent to distant exposure to Rubella. IgM serology testing is limited to suspected Rubella cases. This is not recommended for asymptomatic or pregnant people.
RNA detection- RT-PCR is used to detect Rubella RNA and endpoint RT-PCR is used to amplify the region of the Rubella gemone to determine genotype.
and genetic analysis- virus sequencing of Rubella can lead to whether the sequence is derived from a virus isolate or directly from a clinical speciman, and the location and date of specimen collection.
Interesting Aspects
Interesting Aspects
Rubella is also known as two other names: "German measles" because in Germany it was discovered to be a separate disease from the measles and "Three-Day Measles" because the rash caused by Rubella usually fades after three days.
Citations
Citations
Flint, S. Jane, et al. Principles of Virology. Wiley, 2020
George, Suji, et al. "Molecular Aspects of the Teratogenesis of Rubella Virus." Biological Research,
U.S. National Library of Medicine, 28 Aug. 2019,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712747/
Griffin, Diane E. "Measles Virsus Persistence and Its Consequences." Current Opinion in Virology,
U.S. National Library of Medicine, Apr. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492426/
"Pinkbook: Rubella." Centers for Disease Control and Prevention, 18 Aug. 2021,
https://www.cdc.gov/vaccines/pubs/pinkbook/rubella.html
“Recombinant rubella virus spike glycoprotein E1 (strain F-Therien).” The Native
Antigen Company. 4 April 2022, https://thenativeantigencompany.com/products/rubella-glycoprotein-e1-strain-f-therien-protein/
"Rubella Facts." Rubella Facts - MN Dept. of Health,
“Rubella (German Measles).” Centers for Disease Control and Prevention, 31 Dec. 2020,
“Rubella (German Measles).” Johns Hopkins Medicine, 19 Nov. 2019,
“Rubella.” Mayo Clinic, Mayo Foundation for Medical Education and Research,
“Rubella virus antigens.” Rubella Virus Antigens- Creative Diagnostics,
https://www.creative-diagnostics.com/tag-rubella-virus-antigens-49.htm
"Rubella Virus." Basicmedical Key, 11 Aug. 16, https://basicmedicalkey.com/rubella-virus/
“Rubella Virus.” Rubella Virus - an Overview | ScienceDirect Topics,
https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/rubella-virus
Togaviruses: Rubella Virus - Medical Microbiology - NCBI Bookshelf,
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