Rubella (German Measles) in Children

What is 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  some respiratory symptoms. However, a fetus who contracts rubella from his or her 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.

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 person-to-person by coming in contact with secretions from an 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 except to infected unborn children. The biggest concern is to prevent an infected 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 seven days before the onset of the rash and five to seven 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, malaise, upper respiratory symptoms, 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 syndrome. Rubella that is present at birth (the child contracted it from his or her mother while in utero) can result in many problems, including the following:

    • Cataracts in the eyes

    • Deafness

    • Heart problems

    • Intellectual disability

    • 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 doctor 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 doctor may order blood or urine tests to confirm the diagnosis.

What is the treatment for rubella?

Specific treatment for rubella will be determined by your child's doctor 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 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

How is rubella prevented?

Since the introduction of rubella vaccine, the incidence of rubella has decreased substantially. 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 age 12 to 15 months and then again between age 4 and 6. In addition, girls should have completed rubella vaccination before they reach childbearing age.

Other ways to prevent the spread of rubella:

  • Children should not attend school for seven days after the onset of the rash. Always consult your child's doctor for advice.

  • 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.