RUBELLA (German Measles)

General Information

DEFINITION--A mild, contagious virus illness. Immunization has significantly decreased the number of cases in the U.S. Rubella is likely to cause serious birth defects to the unborn baby of a pregnant woman who develops the disease in the first 3 or 4 months of pregnancy.

BODY PARTS INVOLVED--Skin; lymph glands behind the ears and in the neck.

SEX OR AGE MOST AFFECTED--All ages, but most common in children.

SIGNS & SYMPTOMS-Symptoms are usually quite mild.

• Fever.
• Muscle aches and stiffness, especially in the neck.
• Fatigue.
• Headache.
• Reddish rash on the head and body after the 2nd or 3rd day. The rash lasts 1 or 2 days.
• Swollen lymph glands, especially behind the ears and at the back and sides of the neck.
• Joint pain (adults).

CAUSES--RNA virus spread by person-to-person contact. Patients are contagious from 1 week before the rash appears until 1 week after it fades.

RISK INCREASES WITH

• Springtime weather when epidemics are common.
• Inadequate immunization.
• Crowded living conditions.
• School or day care.
• Immunosuppression due to illness or drugs.

HOW TO PREVENT

• Children should be immunized against rubella at approximately 12-15 months of age and a booster given at ages 5-6 or ages 11-15.
• Non-pregnant women of childbearing age should be immunized if they have not had rubella or been immunized. Pregnancy should be prevented for 3 months following immunization. (If you don't know whether or not you have had rubella, your doctor or local health department can determine it from a blood test.)
• A person, especially a pregnant woman who is exposed to rubella, who has not had it or been immunized, should receive a gamma globulin (antibodies) injection. If taken soon after exposure, the gamma globulin may prevent or reduce the severity of the disease.
• A person should not be immunized if he or she has an altered autoimmune system, as with cancer; currently takes cortisone or anticancer drugs; is receiving radiation therapy; or has an illness with fever.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic laboratory tests normally not needed for rubella; however, culture of the throat, blood, urine or cerebrospinal fluid can confirm the presence of the virus.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• In a pregnant woman, miscarriage or birth defects in the newborn child.
• Encephalitis, thrombocytopenia, agranulocytosis (all very rare).

PROBABLE OUTCOME--Spontaneous recovery in 1 week in children, longer in adults.

How To Treat

GENERAL MEASURES--

• Usually no specific treatment is required; extra rest (if needed) and extra fluid intake are recommended.
• Be sure to contact any pregnant woman who has been exposed to the patient. Exposure includes contact with the infected person 1 week prior to, during or 1 week after the infection. This woman should consult her prenatal doctor immediately.

MEDICATION--For minor discomfort, you may use non-prescription drugs such as acetaminophen. Don't give aspirin to a person younger than 18. Research shows a link between the use of aspirin in children during a virus illness and the development of Reye's syndrome (a type of encephalitis).

ACTIVITY--Get extra rest until the fever disappears. Then limit activities until the day after the rash disappears. Don't expose yourself to others until 1 week after the rash disappears.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of rubella.
• The following occurs during treatment: High fever. Red eyes. Cough or shortness of breath. Severe headache, drowsiness, lethargy or convulsion.
• Unusual bleeding occurs 1 to 4 weeks after the illness (bleeding gums, nose, uterus or scattered blood specks on the skin).