Rubella virus


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Rubella virus


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Prions (Spongiform encephalopathy)


Rubella virus


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USMLE® Step 1 questions

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High Yield Notes

5 pages


Rubella virus

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USMLE® Step 1 style questions USMLE

of complete

An 11-month-old girl is brought to the office by her parents for the evaluation of a rash. The patient had a low-grade fever for the past 2 days which was controlled with acetaminophen. Last night, the patient developed a pink rash on her face that has spread to her body this morning. The patient does not have cough, rhinorrhea, vomiting or diarrhea. The rest of the history is unremarkable. The patient has not received any vaccinations since birth. Temperature is 38.8°C (102°F), pulse is 98/min, respirations are 27/min, and blood pressure is 90/55 mmHg. Physical examination shows small tender lymph nodes in the suboccipital and postauricular region. Oropharyngeal examination is within normal limits. The rash is shown in the image.  

Reproduced from Wikipedia

Which of the following best describes the agent responsible for this patient’s condition?

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Rubella p. 166

cardiac defect association p. 306

cataracts p. 554

heart murmur with p. 298

rash p. 178

ToRCHeS infection p. 181

unvaccinated children p. 183


rubella p. 166, 181, 178

Cataracts p. 554

rubella p. 181

Congenital heart disease p. 304-306

rubella p. 181


rubella p. 181

Blueberry muffin rash

rubella p. 166, 181


rubella p. 181


rubella p. 181


rubella p. 166, 178


rubella p. 166, 181


rubella as p. 164

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Content Reviewers

Viviana Popa, MD


Alex Aranda

Rubella, the infection formerly known as “German Measles,'' is caused by the Rubella virus.

Thanks to vaccination, it’s a disease we see less and less, although because some groups are under-immunized, it’s still possible to see outbreaks.

The Rubella virus is part of the Togaviridae family.

Togaviruses are single-strand RNA viruses surrounded by an icosahedral capsid, which is a spherical protein shell made up of 20 equilateral triangular faces, all within a spherical outer lipid envelope.

They’re also positive sense RNA viruses, which means that their genetic material is actually mRNA, so it can be used right away by the host cell to make viral proteins.

Now, the Rubella virus is transmitted through respiratory droplets, which are released into the environment when you sneeze or cough on another person.

Within the nasopharynx mucous membrane, the virus binds to a specific receptor on the membrane of epithelial cells.

It’s then surrounded by a little section of cell membrane that pinches off to form an endosome, that’s brought into the cell.

The low pH in the endosome uncoats the viral RNA and the virus causes changes to the endosome.

Now, when the Rubella virus enters the cell it also rearranges some of the organelles, gathering the endoplasmic reticulum, golgi apparatus, and mitochondria around the endosome.

The result is a membrane-bound Viral Replication Complex where - like the name says - the virus replicates.

So, after the virus replicates, its structural proteins are synthesized using the rough endoplasmic reticulum and these proteins are then transported to the golgi apparatus to be assembled and surrounded by membrane, a process called viral budding.

The new virus copy eventually exits the cell by exocytosis and enters nearby lymphatic and blood vessels, travelling to lymph nodes where it will replicate once again.

From the lymph nodes, it enters blood vessels again, and spreads to various parts of the body, making its way into various bodily fluids like urine, cerebrospinal fluid, and synovial fluid of joints.


Rubella virus is a single-strand, positive-sense RNA virus of the Togaviruses family, which is known to cause rubella, sometimes referred to as German measles. The virus is spread through respiratory droplets and infects and replicates in mucous membrane cells of the nasopharynx, then does the same in lymph nodes, triggering apoptosis in infected cells. Infected children are often asymptomatic or might have mild symptoms like fever, lymphadenopathy, and a rash, whereas adults tend to show more serious symptoms and get sick longer. Complications of rubella are rare but may include arthritis, encephalitis, and thrombocytopenia. Treatment for Rubella is supportive and prevention involves a live attenuated vaccine.


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