Acute rubella infections mimicking measles in children in Calabar, Nigeria

The clinical diagnosis of rubella is unreliable as the symptoms are often confused with other viral and non-viral exanthematic illnesses. Acquired forms are self-limiting whereas the congenital type has devastating consequences on the foetus. The aim of this study is to highlight rubella infections in children and to draw to the attention of relevant authorities the need for routine rubella immunization for children and women of childbearing ages. This was a prospective cross-sectional study conducted from February to December 2012. Thirty five children aged 2 to 18 years, were referred to selected health facilities in Calabar following reports of symptoms of fever and skin rash, clinically resembling measles. The demographic data of the children were obtained. Blood was collected from each child and sent for measles and rubella IgM ELISA. Data were analysed using SPSS version 16. Of the 35 children with fever and skin rash, 22 were males while 13 were females (1.7:1). Fourteen (40%) of the children were found to be IgM seropositive for rubella. Five (35.7%) of rubella IgM seropositive children were less than five years of age while 7 (50%) were 5-10 years old. There was no significant difference in the seropositivity for rubella IgM antibody according to age and sex of the patients and (P = 12.5). Only one child (2.8%) was positive for measles IgM. Acute rubella infection is clinically indistinguishable from measles and is confirmed to be present in Calabar, Nigeria. We therefore advocate for routine immunisation of children and women of childbearing ages to prevent the damaging effects of rubella to the unborn baby.