What are the key clinical features to consider when diagnosing rubella in a primary care setting?

Key clinical features to consider when diagnosing rubella in primary care include:

• A mild, self-limiting illness typically resolving within a week.
• The presence of a rash, which is a hallmark feature, usually prompting notification and further investigation.
• Associated symptoms may include low-grade fever and lymphadenopathy, particularly posterior auricular and suboccipital lymph nodes (implied from typical rubella presentation though not explicitly detailed in the provided text).
• Exclusion of other infections with similar presentations such as measles and parvovirus B19, often requiring laboratory testing for confirmation.
• In pregnant women, any rash suggestive of rubella warrants immediate notification and urgent investigation due to the risk of congenital rubella syndrome.
• Notification to the local Health Protection Team should be made immediately based on clinical suspicion without waiting for laboratory confirmation, as rubella is a notifiable disease.

Patients should be advised to rest, maintain hydration, and use paracetamol or ibuprofen for symptom relief, avoiding aspirin in children under 16 years.

They should also be advised to stay off work or school for at least 5 days after rash onset and avoid contact with pregnant women to prevent transmission.

Laboratory confirmation is primarily for surveillance and public health purposes rather than individual management in non-pregnant patients.

Urgent referral to secondary care is indicated if complications such as haemorrhagic manifestations or encephalitis are suspected.

Overall, diagnosis in primary care relies on clinical suspicion supported by characteristic rash and epidemiological context, with prompt notification and appropriate advice to the patient.

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