Rubella (German measles)

What is rubella?

Rubella is an acute viral infection. It can cause a rash, fever and swelling of the lymph nodes. It is also known as German measles.

Rubella is usually a mild illness, but it can cause severe abnormalities in the fetus if an individual is infected during pregnancy. These abnormalities are called congenital anomalies.

Signs and symptoms of rubella

Rubella

Rubella is a mild infection in infants and children. Many children do not show any symptoms at all. The infection can be more severe in teenagers and adults. Signs and symptoms may not show until two or three weeks after the infection is in the body.

Some of the signs and symptoms of rubella include:

• slight fever
• swollen lymph nodes at the back of the neck and behind the ears
• a non-itchy rash that:
• usually appears after a few days of fever and feeling unwell
• begins on the face and spreads to the body and limbs
• consists of tiny, flat pink spots that become paler when pressed
• joint pain, which is common in female adolescents and adults, usually occurs after the rash and may last for a few weeks

Not all individuals infected with rubella look the same, and many other conditions can look similar to rubella.

Causes of rubella

The rubella virus is spread through the air by infectious droplets when an infected person coughs, sneezes or touches a surface. People who are not immunized may contract the virus by inhaling or touching these droplets then touching their face, mouth, eyes or ears.

Risk factors

Your child is more likely to contract the illness if:

• your child has not had the measles, mumps and rubella (MMR) vaccination
• your child has travelled internationally without being vaccinated

Diagnosis

Someone who is not immunized and is suspected of having rubella can be diagnosed with blood, urine and nasal swabs. In most jurisdictions, when someone is suspected of having rubella, it will be reported to the local public health unit, and that person will need to isolate for seven days after the rash appears.

Prevention

Rubella can be prevented by immunization with the measles, mumps and rubella (MMR) vaccine. In Canada, two doses are routinely recommended in childhood. The first dose is given after a child’s first birthday, and the second dose is usually given between the age of 18 months and four to six years of age. Individuals who have not received two doses in childhood should be vaccinated before pregnancy.

Complications

The most serious complication of rubella occurs when an individual is infected in the first four months of pregnancy. This can cause miscarriage. Rubella can also severely affect the developing brain, eyes, ears, heart and other organs of the fetus. This condition is called congenital rubella syndrome. Congenital rubella syndrome leads to lifelong health conditions.

Arthritis in the knees, wrists and fingers is a common long-term complication in female adolescents and adults who are infected with rubella. Rarely, rubella can cause low platelet counts, which can result in bleeding. Encephalitis (inflammation of the brain) is another rare complication.

Taking care of your child at home

Follow isolation guidelines.

There is no specific treatment for rubella, but you can help your child by trying to make them comfortable. Usually, children recover completely from rubella within 10 days of the onset of symptoms. Acetaminophen or ibuprofen can be given for fever.

When to seek medical assistance

If you think your child may have rubella, call their health-care provider for advice before entering the office or clinic to reduce the risk of spreading the virus to others.