Health Alert: Rubella Case in Yavapai County, Jan 2010

The Arizona Department of Health Services and Yavapai County Community Health Services recently identified a case of rubella in an unimmunized Yavapai County resident with a history of travel outside of the US. The case had an onset date of 1/26/2010. During the investigation, no susceptible close contacts were identified and the case had no travel outside of Yavapai County while infectious. Currently there are no secondary cases. The last reported case of rubella in Arizona occurred in 2000. 

Rubella may present as a generalized maculopapular rash with a fever of 99.0 degrees or higher and arthalgia, arthritis, lymphadenopathy, or conjunctivitis. Up to 50% of rubella cases may be asymptomatic.  Rubella is a moderately contagious rash illness that can be spread from person to person via droplet transmission. Although the disease is most contagious during the initial appearance of the rash, rubella can be shed by infected individuals up to seven days before the appearance of the rash and 7 days or more after rash onset.

Rubella is especially of concern among pregnant women due to the risk of developing congenital rubella syndrome (CRS). CRS is a fetal condition due to maternal rubella infection that may result in fetal death, spontaneous abortion, premature delivery, and a wide range of congenital defects.  The risk of CRS is highest when infection occurs early in pregnancy, particularly during the first trimester.

This case highlights the importance of MMR vaccination as one of the best methods to prevent rubella infection.  Providers should remind patients at high risk, including pregnant women and children, to receive MMR vaccination.

If you suspect rubella, please notify your local health department as soon as possible so they may assist in the coordination of laboratory testing as well as help initiate control measures. If you have any questions, please contact your local health department or the ADHS Infectious Disease Epidemiology Section at (602) 364-3676.