Rubella (German measles)

Rubella is a viral illness that results in a viral exanthem. Exanthem is another name for a rash or skin eruption. It is spread from one child to another through direct contact with discharge from the nose and throat.

Infants and children who develop the disease usually only have a mild case of the rash and side effects. However, children who contract rubella from their mother while she is pregnant, can have severe birth defects and consequences. It is also very dangerous for pregnant women to come in contact with someone who has rubella, because it may cause a miscarriage. Pregnant women who have been exposed to rubella need to seek medical attention immediately.

What causes rubella?

Rubella is caused by a virus, called a Rubivirus. It can be spread from a pregnant mother to the unborn child, or from secretions from another infected person. It is most prevalent in late winter and early spring. Rubella is preventable by proper immunization with the rubella vaccine.

What are the symptoms of rubella?

The disease itself does not have any long-term consequences. The biggest concern is to prevent an affected child from infecting a pregnant woman. It may take between 14 to 21 days for a child to develop signs of rubella after coming in contact with the disease. It is important to know that a child is most contagious when the rash is erupting. However, the child may be contagious beginning 7 days before the onset of the rash to 14 days after the rash has appeared. Therefore, children may be contagious before they even know they have the disease. The following are the most common symptoms of rubella. However, each child may experience symptoms differently. Symptoms may include:

Childhood rubella

• Rubella may begin with a period of not feeling well, a low-grade fever, and diarrhea. This may last one to five days
• The rash then appears as a pink rash with areas of small, raised lesions
• The rash begins on the face and then spreads down to the trunk, arms, and legs
• The rash on the face usually improves as the rash spreads to the arms and legs
• The rash usually fades by the third to fifth day
• Lymph nodes in the neck may also become enlarged
• Older children and adolescents may develop some soreness and inflammation in their joints

Congenital rubella (rubella that is present at birth; the child contracted it from his/her mother while in utero) can result in many problems, including the following:

• Cataracts in the eyes
• Heart problems
• Mental retardation
• Growth retardation
• Enlarged liver and spleen
• Skin lesions
• Bleeding problems
• The symptoms of rubella may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis

How is rubella diagnosed?

Rubella is usually diagnosed based on a medical history and physical examination of your child. The lesions of rubella are unique, and usually the diagnosis can be made on physical examination. In addition, your child's physician may order blood or urine tests to confirm the diagnosis.

Treatment for rubella:

Specific treatment for rubella will be determined by your child's physician based on:

• Your child's age, overall health, and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

The goal of treatment for rubella is to help prevent the disease, or decrease the severity of the symptoms. Since it is a viral infection, there is no cure for rubella. Treatment may include:

• Increased fluid intake
• Rest

Prevention of rubella:

Since the introduction of rubella vaccine, the incidence of rubella has decreased by more than 99 percent. Most cases today occur in adults who have not been vaccinated. The rubella vaccine is usually given in combination with the measles and mumps vaccine. It is called the MMR vaccine. It is usually given when the child is 12 to 15 months old, and then again between 4 to 6 years of age.

Other ways to prevent the spread of rubella:

• Children should not attend school for seven days after the onset of the rash
• Children who are born with rubella are considered contagious for the first year of life
• Assure that all of your child's contacts have been properly immunized