Vaccine-associated Rubella - a report of two cases and a review of the literature.

Ong, Sean Wei Xiang; Vasoo, Shawn; Sadarangani, Sapna P; Cui, Lin; Marimuthu, Kalisvar; Lim, Poh Lian; Kong, Jing Wen; Wong, Judith Chui Ching; Puong, Kim Yoong; Chan, Kwai Peng

We report the clinical characteristics of two adult patients, presenting with a typical erythematous rash consistent with rubella disease after MMR vaccination. Both patients had an uncomplicated clinical course and recovered uneventfully. One patient was confirmed to have vaccine-associated rubella via sequencing of virus isolated in viral culture. The other patient had a pharyngeal swab positive for rubella virus PCR, with sequencing matching the vaccine strain. There are few reports of clinical disease from rubella vaccine-strains in the literature. Previous authors have reported severe disseminated vaccine-associated rubella in both immunodeficient and immunocompetent patients. Further study is required to ascertain the incidence, risk factors, and clinical characteristics of this condition; as well as investigate the extent of horizontal transmission to guide infection control recommendations.