Definition Rubella, or German measles, is a viral infection characterised by a rash.
What is going on in the body? The rubella virus is spread when uninfected people come in contact with secretions from infected persons. Most frequently, this is due to exposure to droplets from coughs and sneezes and mucous from the nose. Rubella can also be passed from a mother to her foetus during pregnancy.
What are the signs and symptoms of the infection? About half the time there are no symptoms. Symptoms that do occur are usually mild and begin about 2 to 3 weeks after acquiring the virus. Symptoms include slight fever and rash. The rash is not unique and may appear on the face first as flat or slightly raised red spots. It may then spread to the body, arms and legs. Low-grade fever for a day or two, followed by joint pains may occur. Some people have swelling and redness of the joints. Rarely, people may have low counts of cells involved in blood clotting, called platelets. Encephalitis (en-sef-ah-lite-is), an infection involving the brain, may also rarely occur.
Infection in a foetus can cause many serious problems in the infant, including:
cataracts, or cloudiness in the eye that can decrease vision
heart defects
deafness
mental retardation
an enlarged liver and spleen
low blood counts
a rash, often with purple skin lesions
What are the causes and risks of the infection? The rubella virus causes this infection. The main risks of this infection are related to brain involvement or infections in a foetus. Either of these cases may result in permanent brain damage or death. Infections in a foetus may cause multiple severe defects in the newborn.
What can be done to prevent the infection? The rubella vaccine is very effective at preventing this infection. In children, the vaccine is usually combined with the measles and mumps vaccine and given as one Injection, which is called the MMR vaccine. Women of childbearing age who are not pregnant should make sure they have received this vaccine. Possible side effects of the MMR vaccine include:
fever and rash, which may occur 1 to 2 weeks after the vaccine
Other side effects are rare. The vaccine should not be given to pregnant women or to women who are planning on getting pregnant in the 3 months after the Injection.
Isolating an infected person can also help prevent spread of this infection. An infected person should stay home from school or work for 7 days after the rash appears. Infants exposed to the virus prior to their birth may be contagious for more than a year after birth. Special care should be taken to keep them away from people who haven't received the vaccine.
How is the infection diagnosed? This infection is usually diagnosed by testing for proteins in the blood called antibodies. Antibodies are made by the body to fight germs and other foreign substances. The virus can also be isolated from infected lung, throat, or nose secretions. In some cases, the doctor may recognise the rash and not need to do any further tests.
What are the long-term effects of the infection? The main concern with rubella is its impact on a pregnant woman and her unborn child. If a woman is affected in the first three months of pregnancy, the chances that the baby will develop problems can be very high. Infections in a foetus may result in blindness, deafness, heart defects and mental retardation. Any pregnant woman who has not received the rubella vaccine and is exposed to the virus should consult with her doctor.
Most others with this infection recover fully and have no long-term effects.
What are the risks to others? Rubella can be spread to other people. A woman also can pass the virus to her foetus during pregnancy.
What are the treatments for the infection? Home treatment, if needed, may include over-the-counter medication, such as paracetamol, for fever or joint pain. However, children should not take aspirin when they have rubella, because it can cause a severe brain inflammation called Reye's syndrome. There are no antibiotics available for this infection.
What are the side effects of the treatments? Over-the-counter drugs, like all drugs, have possible side effects. Drugs used for fever and pain may cause allergic reactions, stomach upset, and other side effects. Specific side effects depend on the drugs used.
What happens after treatment for the infection? People generally get better within a week. They can return to normal activities one week after the rash appears. Pregnant women who become infected early in the pregnancy may want to consider having an abortion due to the high risks of severe damage to the foetus.
How is the infection monitored? Most people can monitor the infection at home, as it is usually mild. Pregnant women may be advised to have repeat ultrasounds. An ultrasound is a special x-ray test that uses sound waves. It allows the foetus to be seen inside the mother's womb. This may allow early detection of birth defects.
Author: Danielle Zerr, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
