title: Genomic characterization of a persistent rubella virus from a case of Fuch' uveitis syndrome in a 73 year old man.
abstract: BACKGROUND
  Many cases of Fuchs' uveitis have been associated with persistent rubella virus infection. A 73-year-old male patient with typical Fuchs' Uveitis Syndrome (FUS) first experienced heterochromia of the left eye at the age fourteen, when rubella was endemic in the US.
  
  
  OBJECTIVE
  The purposes of this report are to describe the patient's FUS clinical presentations and to characterize the virus detected in the vitreous fluid.
  
  
  METHODS
  The patient underwent a therapeutic pars plana vitrectomy in May 2013. A real-time RT-PCR assay for rubella virus was performed on the vitreous fluid by Focus Diagnostics. Additional real-time RT-PCR assays for rubella virus detection and RT-PCR assays for generation of templates for sequencing were performed at the Centers for Disease Control and Prevention (CDC).
  
  
  RESULTS
  The results from Focus Diagnostics were positive for rubella virus RNA. Real-time RT-PCR assays at CDC were also positive for rubella virus. A rubella virus sequence of 739 nucleotides was determined and phylogenetic analysis showed that the virus was the sole member of a new phylogenetic group when compared to reference virus sequences.
  
  
  CONCLUSIONS
  While FUS remains a clinical diagnosis, findings in this case support the association between rubella virus and the disease. Phylogenetic analysis provided evidence that this rubella virus was likely a previously undetected genotype which is no longer circulating. Since the patient had rubella prior to 1955, this sequence is from the earliest rubella virus yet characterized.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: efa9@cdc.gov.
authors.forename: Emily
authors.initials: E
authors.lastname: Abernathy
authors.affiliation: Northeastern Eye Institute, Scranton, PA, USA. Electronic address: rpeairs@epix.net.
authors.forename: Randall R
authors.initials: RR
authors.lastname: Peairs
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: zvp8@cdc.gov.
authors.forename: Min-hsin
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: jci1@cdc.gov.
authors.forename: Joseph
authors.initials: J
authors.lastname: Icenogle
authors.affiliation: Clin-Micro Immunology Center, Clarks Summit, PA, USA. Electronic address: hnamdari@clinmicro.com.
authors.forename: Hassan
authors.initials: H
authors.lastname: Namdari
mesh_terms: D000368:Aged; D015828:Eye Infections, Viral / Q000150:complications / Q000821:virology*; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications; D005838:Genotype; D006801:Humans; D008297:Male; D010802:Phylogeny; D012367:RNA, Viral / Q000032:analysis; D012409:Rubella / Q000175:diagnosis* / Q000821:virology; D012412:Rubella virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D014605:Uveitis / Q000150:complications* / Q000821:virology
chemical_list: D012367:RNA, Viral
keywords: Fuchs’ uveitis syndrome; Genomic characterization of rubella virus; Rubella virus