Rubella (German measles)

Dr. Parang Mehta, MD.

German measles is one of the common rash associated viral diseases of childhood.  It is caused by a virus, named the Rubella virus.  Unlike measles, though, rubella is usually a mild illness.  Indeed, it is often so mild that it goes unnoticed.

Though rubella itself is not a very dangerous illness, it is important becuae of its effects on the unborn baby.  If a pregnant woman gets rubella, the baby can be severely affected, with long lasting effects in many different systems (see Congenital Rubella Syndrome, below).

Rubella - The Disease

Rubella makes its appearance 14-21 days after the child was infected.  Two thirds of infected children have a subclinical disease -- it is not noticed or diagnosed at all.  

Rubella starts with fever, respiratory symptoms, and tender swelling of the lymph nodes.  The rash appears first on the face, and progresses down the body.   Usually, the rash lats for three days, which is why rubella is also known as Three Day Measles.   Occasionally it is so transient that it may fade from the face by the time the trunk is affected.   Rubella is known to occur without rash.  

A characteristic feature of rubella is lymph node enlargement.  Lymph nodes in the neck and scalp become enlarged and painful.  This usually starts before the rash, and lasts about a week.

Almost all children recover completely from rubella.  Most people have lifelong immunity to rubella after one attack.

Treatment of Rubella

Rubella is a mild and short-lived disease, and requires no specific treatment.  Rest, a nutritious diet, and some fever medicine is all that is usually required.

Spread of Rubella

Rubella virus is present in nasal secretions, coughed droplets, and other body fluids.  The virus is shed for a week before the illness is noticeable.  Virus is also present for a week after the rash disappears.

Rubella is spread by coughed droplets, direct contact, shared objects like towels, etc.  Since an affected person is infective for a week before the disease becomes known, avoidance is impossible.  Individual protection by vaccination is the reliable way of avoiding rubella.

Once rubella is known, affected children should not go to school/daycare, and should stay away for 5 days after the rash has subsided.

Congenital Rubella Syndrome

This is a serious complication that occurs when a pregnant woman gets rubella infection.  The unborn baby gets infected across the placenta, and this congenital rubella affects almost all organs and systems.  Most babies with congenital rubella syndrome are born small, though they are not premature -- they have intrauterine growth retardation (see Low Birth Weight Babies).   The other problems with congenital rubella syndrome are:

Congenital rubella syndrome is a major, lifelong problem for a family.  Avoiding congenital rubella syndrome is the chief reason efforts at preventing spread of rubella are made.

Last Revision: February 16, 2016

Rubella vaccination

Rubella vaccination of every child is the best way to cut down the spread of rubella, and in the long term, reducing the occurrence of the congenital rubella syndrome.  It is a live vaccine, consisting of rubella virus which has been weakened to the point where it causes no illness, but does provoke the immune system of the body.

The vaccine is not effective below the age of one year.  Antibodies passed to the child from the mother persist in the child's bloodstream for upto a year, and so the rubella vaccine should be given after this age.  Though the rubella vaccine is available separately, it is usually used as a combination with measles and mumps vaccines (The MMR vaccine).

The Rubella vaccine provides protection to over 90% of recipients.  After one dose of vaccine at 12-15 months, a second dose should be given between the ages of 4 and 6 years.  If some doses have been missed, children should be vaccinated at 11-12 years.

Rubella vaccine is especially important for girls.  All girls must be immunised before they reach childbearing age.  This measure has reduced the occurrence of congenital rubella syndrome in many countries to near zero levels.

Contact Information

Dr. Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat, India.    Tel: +91 9429486624.