Read through the patients´ history below. Select Next or Previous at the bottom of the screen to move to the next part of the tutorial. At any point you can select the Pause/Resume button to save your position in the case history.
Present History
- Parents' English is limited.
- Interaction with the doctor is mainly through the husband.
- Recent cases of rubella at Aicha's school over the last four weeks.
- On the day after her 9th birthday party Aicha developed a mild fever and rash (shown below)
- Aicha complains of headache and tiredness.
- Both parents work and Aicha's auntie, Fatima, babysits her.
- Fatima had contact with Aicha before and at the birthday party the previous weekend, and thinks she is pregnant.
Past medical history: Aicha
- Aicha was born shortly after the Mehannas emigrated from Iraq.
- Aicha's medical records are with the Mehannas' previous GP in another suburb.
- Mother reports no serious medical problems.
- Aicha was immunised with triple antigen and polio vaccine during her first year of life.
- Parents not sure whether she completed the full course of injections or had any other vaccinations.
- Not sure whether Aicha has had rubella infection previously.
Past medical history: Fatima
- Aged 25; last menstrual period was 10 weeks ago.
- Experiencing some morning sickness and breast tenderness.
- Previous health excellent.
- Two previous pregnancies uneventful in Iraq.
- Not sure about immunisation.
- Not sure about previous infection with rubella.
Family history
- Aicha's parents migrated from Iraq 10 years ago, shortly before Aicha was born.
- The Mehannas have two older children (sons aged 12 and 15).
- Both parents work as factory process workers.
- The Mehannas recently moved to the area to be close to Mrs Mehanna's younger sister, Fatima Khoury, and her husband.
- Fatima and her husband Ali Khoury recently emigrated from Iraq.
- The Khourys have two young children: a boy and a girl aged 2 and 4 years respectively, both born in Iraq.
- Mr Khoury works at night at local service station.
References
Sir Norman Gregg’s original article linking rubella and congenital cataracts and other abnormalities
www.ncbi.nlm.nih.gov/pmc/articles/PMC2272051/
Australian immunisation handbook and the Australian immunisation scheduleon the Dept of Health website
http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/home
NSW health factsheet – infectious diseases: rubella’
http://www.health.nsw.gov.au/Infectious/factsheets/Factsheets/rubella.pdf