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Disease Name: Rubella


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Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Idaho Department of Health and Welfare. (2016). Investigative Guidelines. Boise, ID:  Division of Public Health.


Overview / Case Definition

Case classification

Confirmed

A case with or without symptoms who has laboratory evidence of rubella infection confirmed by one or more of the following laboratory tests:

OR

An illness characterized by all of the following:

Probable

In the absence of a more likely diagnosis, an illness characterized by all of the following:

Suspected

Any generalized rash illness of acute onset that does not meet the criteria for probable or confirmed rubella or any other illness.


Restrictions

Daycare Facility

A person who is diagnosed with rubella must not work in any occupation in which there is close contact with children in a daycare facility as long as the disease is in a communicable form.

Health Care Facility

A person who is diagnosed with rubella must not work in any occupation in which there is close contact with other persons in a health care facility as long as the disease is in a communicable form.

Schools

A person who is diagnosed with rubella must not attend, be present, or work in any occupation in which there is close contact with children or other persons in a private, parochial, charter, or public school as long as the disease is in a communicable form.

Personal Contact

A person who is diagnosed with rubella must not work in occupations in which there is close contact with women likely to be pregnant as long as the disease is in a communicable form.


Reporting

Within 1 working day

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable: Yes

Reporting Timeframe: Within 1 working day



Diagnosis / Testing

Laboratory confirmation of rubella requires any one of the following:

  1. Positive IgM not explained by MMR vaccination during the previous 6–45 days and not otherwise ruled out by more specific testing in a public health laboratory (may not be detectable before 4–5 days after rash onset, can persist for 6 weeks after rash onset. False positives have been reported in persons with other viral infections (e.g., acute Epstein-Barr infection, recent cytomegalovirus infection, and parvovirus infection), or in the presence of rheumatoid factor.
  2. Significant rise in IgG between acute (as soon as possible after illness onset) and convalescent titers (1–3 weeks later). In most cases, rubella IgG is detectable by 8 days after rash onset. [Note: assays for IgG avidity are useful to distinguish the difference between recent and past rubella infections. These are not routine tests.]
  3. Isolation of rubella virus.
  4. Detection of rubella virus by PCR.

Rubella virus can be detected from nasal, throat, urine, blood, and CSF specimens from persons with rubella. The best results come from throat swabs. Specimens submitted for virus isolation or PCR may be submitted to the Idaho Bureau of Laboratories (208-334-2235). Specimens for virus isolation should be obtained in cases of rubella occurring within 10 days of rubella vaccination to determine if the rash is attributable to vaccine virus or wild virus.

Laboratory confirmation of CRS requires any one of the following:

  1. Infant rubella antibody level that persists at a higher level and for a longer period than expected from passive transfer of maternal antibody (e.g., rubella titer that does not drop at the expected rate of a twofold dilution per month). Infants with symptoms consistent with CRS who test negative soon after birth should be retested at age 1 month.
  2. Isolation of rubella virus.
  3. Detection of virus by PCR.
  4. Detection of rubella-specific IgM.

Specimens submitted for virus isolation or PCR may be submitted to the Idaho State Bureau of Laboratories (208-334-2235).


Treatment

Prevention of Rubella and Congenital Rubella Syndrome:  http://www.cdc.gov/mmwr/pdf/rr/rr6204.pdf


Additional Information

Idaho Department of Health and Welfare. (2016). Investigative Guidelines. Boise, ID:  Division of Public Health.


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