Serological study of rubella-like illnesses

Area of Science:

• Virology
• Immunology
• Epidemiology

Background:

• Rubelliform rash and arthralgia are common symptoms that can be caused by various infections.
• Clinical diagnosis of rubella can be challenging due to overlapping symptoms with other viral exanthems.

Purpose of the Study:

• To investigate the aetiology of rubelliform rash and/or arthritis/arthralgia in a cohort of patients.
• To differentiate between rubella, human parvovirus B19 (HPV), and measles infections in patients presenting with these symptoms.

Main Methods:

• Serological testing for specific IgM and IgG antibodies against rubella, HPV, and measles.
• Complement fixation tests were used to screen for other infectious agents.
• Clinical data collection on symptoms, duration, and outcomes.

Main Results:

• Out of 627 patients, 229 had rubella, 43 had HPV infection, and 7 had measles.
• A significant proportion (54%) of rubelliform rashes remained undiagnosed.
• HPV infection mimicked rubella symptoms, particularly in seasonal incidence and clinical presentation, with arthralgia being more frequent in adults with HPV.
• Three cases of HPV infection during pregnancy were noted, with two resulting in spontaneous abortion.

Conclusions:

• Clinical diagnosis of rubella is unreliable; serological confirmation is essential.
• Human parvovirus B19 is a significant cause of rubelliform rashes, often mistaken for rubella.
• HPV infection is generally self-limiting but can cause prolonged symptoms and has potential implications during pregnancy.