Rubella is a viral illness that most often presents as a self-limiting illness in children but can have devastating effects on the fetus when acquired during pregnancy. It was first described in the 1750s and is often referred to as “German measles” due to its characteristic rash that is similar to measles and the attention it received in German literature.
Suspicion of rubella infection is largely based on immune status and potential for exposure. Rubella is rare in countries with effective national immunisation programs, such as New Zealand. Most cases of rubella occur in nonimmune patients who either live in or have traveled to a country with rubella endemicity or a known outbreak. The virus is generally isolated from the pharynx one week before to two weeks after the rash.
The rubella virus causes German measles, a generally mild infection with a characteristic rash that can affect both children and adults. However, rubella infection can cause congenital anomalies (eg, hearing loss; cataracts); cardiac disease; and neurodevelopmental effects) if it occurs early in fetal life.
Microbiology - Virology
German measles - RNA
Please discuss with a CHL Microbiologist if testing is urgent.
Nasopharyngeal swab in VTM. Collection packs can be ordered by emailing LabInfo@cdhb.health.nz. If packs are not available, green top viral swabs are acceptable, or a dry swab snapped into a VTM tube. DO NOT place swabs in bacterial transport medium as this is inhibitory to PCR and cannot be processed.
CSF - Minimum of 2.0 mL into a sterile CSF tube. Transport ASAP to laboratory.
Fresh placental biopsy - Biopsy placed in sterile container. Transport ASAP to laboratory.
Chilled (2 - 8 degrees Celsius)
Refer to specimen collection protocol
Rubella virus RNA detection by RT-PCR.
$396.46 (Exclusive of GST)
The value of prenatal diagnosis of rubella infection by PCR is unknown. An in utero detection of rubella RNA indicates infection of the mother and foetus but cannot predict disease or an adverse outcome to the foetus.
Encephalitis is an unusual complication of rubella. Its application for diagnosis to encephalitis is not well known.
Rubella virus PCR has been used to detect rubella RNA in chorionic villi, placenta, amniotic fluid, foetal blood and lens tissue.
Rubella virus PCR should be requested during early illness (first 7 days after rash onset). After this serology can be considered (Rubella IgM remaining positive for up to 30-60 days). If in doubt please consult a Clinical Microbiologist.
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