About Rubella
Rubella - commonly known as German measles or 3-day measles - is
an infection that primarily affects the skin and lymph nodes. It is
caused by the rubella virus (
not
the same virus that causes measles), which is usually transmitted
by droplets from the nose or throat that others breathe in. It can
also pass through a pregnant woman's bloodstream to infect her
unborn child. As this is a generally mild disease in children, the
primary medical danger of rubella is the infection of pregnant
women, which may cause congenital rubella syndrome in developing
babies.
Before a
vaccine
against rubella became available in 1969, rubella epidemics
occurred every 6 to 9 years. Kids ages 5 to 9 were primarily
affected, and many cases of congenital rubella occurred as well.
Now, due to immunization of children, there are much fewer cases of
rubella and congenital rubella.
Most rubella infections today appear in young, non-immunized
adults rather than children. In fact, experts estimate that 10% of
young adults are currently susceptible to rubella, which could pose
a danger to any children they might have someday.
Signs and Symptoms
Rubella infection may begin with 1 or 2 days of mild
fever
(99-100º Fahrenheit, or 37.2-37.8º Celsius) and swollen, tender
lymph nodes, usually in the back of the neck or behind the ears. A
rash then appears that begins on the face and spreads downward. As
it spreads down the body, it usually clears on the face. This rash
is often the first sign of illness that a parent notices.
The rubella rash can look like many other viral rashes. It
appears as either pink or light red spots, which may merge to form
evenly colored patches. The rash can itch and lasts up to 3 days.
As the rash clears, the affected skin occasionally sheds in very
fine flakes.
Other symptoms of rubella, which are more common in teens and
adults, may include: headache; loss of appetite; mild
conjunctivitis
(inflammation of the lining of the eyelids and eyeballs); a stuffy
or runny nose; swollen lymph nodes in other parts of the body; and
pain and swelling in the joints (especially in young women). Many
people with rubella have few or no symptoms at all.
When rubella occurs in a pregnant woman, it may cause congenital
rubella syndrome, with potentially devastating consequences for the
developing fetus. Children who are infected with rubella before
birth are at risk for growth retardation; mental retardation;
malformations of the heart and eyes; deafness; and liver, spleen,
and bone marrow problems.
Contagiousness
The rubella virus passes from person to person through tiny
drops of fluid from the nose and throat. People who have rubella
are most contagious from 1 week before to 1 week after the rash
appears. Someone who is infected but has no symptoms can still
spread the virus.
Infants who have congenital rubella syndrome can shed the virus
in urine and fluid from the nose and throat for a year or more and
may pass the virus to people who have not been immunized.
Prevention
Rubella can be prevented by a rubella vaccine. Widespread
immunization against rubella is critical to controlling the spread
of the disease, thereby preventing birth defects caused by
congenital rubella syndrome.
The vaccine is usually given to children at 12 to 15 months of
age as part of the scheduled
measles
-
mumps
-rubella (MMR) immunization. A second dose of MMR is generally
given at 4 to 6 years of age. As is the case with all immunization
schedules, there are important exceptions and special
circumstances. Your child's doctor will have the most current
information.
The rubella vaccine should not be given to pregnant women or to
a woman who may become pregnant within 1 month of receiving the
vaccine. If you are thinking about becoming pregnant, make sure
that you are immune to rubella through a blood test or proof of
immunization. If you're not immune, you should receive the
vaccine at least 1 month before you become pregnant.
Pregnant women who are not immune should avoid anyone who has
the illness and should be vaccinated after delivery so that they
will be immune during any future pregnancies.
Incubation
The incubation period for rubella is 14-23 days, with an average
incubation period of 16-18 days. This means that it can take 2-3
weeks for a child to get rubella after they are exposed to someone
with the disease.
Duration
The rubella rash typically lasts 3 days. Lymph nodes may remain
swollen for a week or more, and joint pain can last for more than 2
weeks. Children who have rubella usually recover within 1 week, but
adults may take longer.
Professional Treatment
Rubella cannot be treated with antibiotics because antibiotics
do not work against viral infections. Unless there are
complications, rubella will resolve on its own.
Any pregnant woman who has been exposed to rubella should
contact her obstetrician immediately.
Home Treatment
Rubella is typically a mild illness, especially in kids.
Infected children usually can be cared for at home. Monitor your
child's temperature, and call the doctor if the fever climbs
too high.
To relieve minor discomfort, you can give your child
acetaminophen or ibuprofen. Avoid giving aspirin to a child who has
a viral illness because its use in such cases has been associated
with the development of
Reye syndrome
, which can lead to liver failure and death.
When to Call the Doctor
Call the doctor if your child develops a fever of 102º
Fahrenheit (38.9º Celsius) or above (in a child younger than 6
months, call for a fever above 100.4º Fahrenheit, or 38º Celsius),
or if your child appears to be getting sicker than the mild course
of symptoms described above.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: July 2006
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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