Rubella (German Measles): Signs and Symptoms
Childhood Infections.


Signs and Symptoms:
Rubella infection is commonly known as "German measles" or "3-day measles." It may begin with 1 or 2 days of mild fever (99 degrees F to 100 degrees F) and swollen glands that are usually found either in the neck or behind the ears. On the second or third day, a rash appears that begins at the hairline and spreads downward on the rest of the body. As the rash spreads downward on the body, it usually clears on the face. The rubella rash appears as either pink or light red spots, about 0.1 inches (2 to 3 mm) in diameter, which may merge to form evenly colored patches. The rash doesn't itch, and lasts up to 5 days (the average is 3 days). As the rash passes, the affected skin may be shed in flakes.

Other symptoms of rubella may include: mild conjunctivitis (inflammation of the lining of the eyelids and eyeballs); stuffy or runny nose; swollen lymph glands in other regions of the body; pain and swelling in the joints (especially in young women); and in males, pain in the testicles.

When rubella occurs in a pregnant woman, it may cause congenital rubella syndrome with serious malformations of her developing fetus. Children infected with rubella before birth (a condition known as congenital rubella) are at risk for the following: growth retardation; malformations of the heart, eyes, or brain; deafness; and liver, spleen, and bone marrow problems.

Rubella is an infection that primarily affects the skin and lymph glands. It is caused by the rubella virus, which can be found in the throat, blood, and stool of an infected person. The virus usually enters the body through the nose or throat, but it can also pass through a pregnant woman's bloodstream to infect her unborn child. Since this is a generally mild disease in children, the primary medical danger of rubella is the infection of pregnant women, which may potentially cause congenital rubella syndrome in the developing infant.

Before a vaccine against rubella became available in 1969, there were rubella epidemics every 6 to 9 years. Those primarily affected by rubella were children ages 5 to 9 and adults, but there were also many cases of congenital rubella. Now, due to immunization of younger children and teens, fewer cases of congenital rubella occur. Estimates are that 10% of young women of childbearing age are currently susceptible to rubella; obstetricians usually will check for immunity.

The term "German" has nothing to do with the country, but probably came from the Old French term "germain" and the Latin term "germanus," meaning "akin to" or "similar."

The rubella rash may last from 1 to 5 days, but 3 days is the most common duration. Children with rubella usually recover in 1 week, but adults may take longer.

The rubella virus passes from person to person through droplets and fluids from the nose and throat. Persons with rubella are contagious from 1 week before the rash appears until 1 week after it fades.

The incubation period for rubella is 14 to 21 days; 18 days is the average incubation period.

Rubella can be prevented by a rubella vaccine, which is usually given to children at 12 to 15 months 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, but should be given no later than 11 to 12 years of age. The rubella vaccine should not be given to pregnant women or to a woman who may become pregnant within 3 months of receiving the vaccine.

When to Call Your Child's Doctor
Call your child's doctor if your child develops a fever over 101 degrees F or if he appears to be getting sicker than the mild course of symptoms described above.

If you are contemplating getting pregnant, make sure that you are immune to rubella through a blood test or proof of immunization. If you are pregnant and you are exposed to rubella, call your obstetrician immediately.

Professional Treatment:
Rubella cannot be treated with antibiotics, since antibiotics do not work against viral infections.

Any pregnant woman who has been exposed to rubella should contact her obstetrician immediately.

Home Treatment:
Rubella is usually a mild illness, especially in children. To relieve minor discomfort, give acetaminophen. Record the child's temperature once each morning and each evening. Call your child's doctor for fever above 101 degrees F.

Avoid giving aspirin to a child who has a viral illness since the use of aspirin in such cases has been associated with the development of Reye's syndrome.

This document is from the Kids Health site.

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