Arthritis Associated with Induced Rubella Infection

Rubella antibody activity in serum, nasopharynx and joint aspirates, and recovery of rubella virus from joint aspirates was studied in three previously well children, and one child with pre-existing rheumatoid arthritis, who developed repeated episodes of arthritis with effusion for several months following parenteral immunization with live attenuated rubella vaccine (HPV-77 DK/12). Three months after immunization, rubella antibody activity in serum was present in the γG and to a smaller extent in γM class of immunoglobulin. No rubella antibody response was demonstrable in the nasopharynx. The response in joint aspirates was limited to the γG class of immunoglobulin in all children studied. Rubella virus was recovered from the joint aspirates of all previously well children for as long as 3 to 4 months after immunization with rubella virus vaccine. It is suggested that repeated episodes of arthritis which follow rubella immunization may be related to the continued presence of rubella virus in the affected joints, and to a selective distribution of rubella virus antigen in synovial and other body fluids.