About Rubella

Rubella commonly known as German measles or 3-day measles is an infection that primarily affects the skin and lymph nodes. It is caused by the rubella virus (not the same virus that causes measles), which is usually transmitted by droplets from the nose or throat that others breathe in. It can also pass through a pregnant woman's bloodstream to infect her unborn child. It's a generally mild disease in children; the primary medical danger of rubella is the infection of pregnant women because it can cause congenital rubella syndrome in developing babies. Before a vaccine against rubella became available in 1969, rubella epidemics occurred every 6-9 years, most often among kids 5 to 9 years old. Many cases of congenital rubella occurred as well. Thanks to immunization, there are far fewer cases of rubella and congenital rubella. Most rubella infections today appear in young, non-immunized adults rather than in kids. In fact, experts estimate that 10% of young adults are currently susceptible to rubella, which could pose a danger to children they might have someday.

Signs and Symptoms

Rubella infection may begin with 1-2 days of mild fever (99-100F, 37.2-37.8C) and swollen, tender lymph nodes, usually in the back of the neck or behind the ears. A rash then begins on the face and spreads downward. As it spreads, it usually clears on the face. This rash is often the first sign of illness that a parent notices. The rubella rash can look like many other viral rashes. It appears as either pink or light red spots, which may merge to form evenly colored patches. The rash can itch and lasts up to 3 days. As the rash clears, the affected skin occasionally sheds in very fine flakes. Other symptoms of rubella (these are more common in teens and adults) can include headache, loss of appetite, mild conjunctivitis(inflammation of the lining of the eyelids and eyeballs), a stuffy or runny nose, swollen lymph nodes in other parts of the body, and pain and swelling in the joints (especially in young women). Many people with rubella have few or no symptoms. Rubella in a pregnant woman can cause congenital rubella syndrome, with potentially devastating consequences for the developing fetus. Children who are infected with rubella before birth are at risk for growth retardation; mental retardation; malformations of the heart and eyes; deafness; and liver, spleen, and bone marrow problems.

Contagiousness
The rubella virus passes from person to person through tiny drops of fluid from the nose and throat. People who have rubella are most contagious from 1 week before to 1 week after the rash appears. Someone who is infected but has no symptoms can still spread the virus. Infants who have congenital rubella syndrome can shed the virus in urine and fluid from the nose and throat for a year or more and may pass the virus to people who have not been immunized.

Prevention
Rubella can be prevented by the rubella vaccine. Widespread immunization against rubella is critical to controlling the spread of the disease, thereby preventing birth defects caused by congenital rubella syndrome. The vaccine is usually given to children at 12-15 months of age as part of the scheduled measles-mumpsrubella (MMR) immunization. A second dose of MMR is generally given at 4-6 years of age. As is the case with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor will have the most current information. The rubella vaccine should not be given to pregnant women or to a woman who may become pregnant within 1 month of receiving the vaccine. If you are thinking about becoming pregnant, make sure that you're immune to rubella through a blood test or proof of immunization. If you're not immune, you should receive the vaccine at least 1 month before you become pregnant.

Pregnant women who are not immune should avoid anyone who has the illness and should be vaccinated after delivery so that they will be immune during any future pregnancies.

Incubation
The incubation period for rubella is 14-23 days, with an average incubation period of 16-18 days. This means that it can take 2-3 weeks for a child to get rubella after they are exposed to someone with the disease.

Duration
The rubella rash usually lasts 3 days. Lymph nodes may remain swollen for a week or more, and joint pain can last for more than 2 weeks. Children who have rubella usually recover within 1 week, but adults may take longer.

Treatment
Rubella cannot be treated with antibiotics because they do not work against viral infections. Unless there are complications, rubella will resolve on its own. Any pregnant woman who has been exposed to rubella should contact her obstetrician immediately. Rubella is typically mild in kids, who often can be cared for at home. Monitor your child's temperature and call the doctor if the fever climbs too high. To relieve minor discomfort, you can give your child acetaminophen or ibuprofen. Do not give aspirin to a child with a viral illness because such use has been associated with the development of Reye syndrome, which can lead to liver failure and death.

When to Call the Doctor

Call the doctor if your child develops a fever of 102F (38.9C) or above (in a child younger than 6 months, call for a fever above 100.4F, or 38C), or if your child appears to be getting sicker than the mild course of symptoms described above.

Rubella (German measles) in pregnancy

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What is rubella? Rubella (German measles) is an infection that is caused by a virus. It is less serious than red measles, except in pregnant women. Rubella usually causes a low-grade fever and mild cold-like symptoms followed by a rash. Glands in the neck may swell up. The sickness lasts for about 3 days. People often do not know they have rubella because the disease is so mild. Their doctor may tell them they likely have rubella, but only a blood test can tell for certain. Rubella is now rare in Canada because most children are vaccinated against it (as part of the measles-mumps-rubella [MMR] vaccine). How does rubella spread? Rubella spreads by close contact among people, such as living in the same house or sharing an office. Sneezing and coughing can spread rubella. You are very unlikely to catch rubella in a shopping mall or in crowded areas.

What about pregnant women and rubella? Fortunately, rubella in pregnancy is now a rare problem in Canada because most women have been vaccinated against it. The vaccine prevents most but not allrubella infections during pregnancy. If a pregnant woman is not immune to rubella and catches it during the first 5 months of pregnancy, she usually passes the disease on to her fetus. If the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many problems. The most common are eye problems, hearing problems and heart damage. If the fetus gets rubella between 12 and 20 weeks of pregnancy, problems are usually milder. If the fetus gets rubella after 20 weeks of pregnancy, there are usually no problems. There is no treatment for rubella infection. The damage that happens to the fetus will last for the childs whole life. What can you do to prevent rubella while you are pregnant? Before you get pregnant, speak to your doctor. If you are not sure whether you have had a rubella vaccine, you should have a blood test. The test will tell you if you are protected against rubella. If you have had rubella infection or have the antibodies from the rubella vaccine, you are most likely protected. If the blood test shows you are not protected against rubella, you should get the MMR vaccine right away. You cannot get this vaccine when you are pregnant. If you are pregnant, avoid contact with people who have rashes that cover most of their body and that have been present for less than one week. How safe is the MMR vaccine? This vaccine is very safe. The only people who should not receive the MMR vaccine are those who have had trouble breathing or have had hives or swelling in the mouth after a previous rubella or MMR shot, and people who have illnesses that affect the immune system. There may be some redness, swelling or pain where the needle went into the arm or leg. Some people will have a fever and a rash, and others will have joint pains that usually last for a few days.

Rubella (German measles) in pregnancy

Approved by the BabyCentre Medical Advisory Board Last reviewed: July 2011 [Show references]

What is rubella? If I get rubella during pregnancy will it harm my baby? How will I know if I'm immune to rubella? What should I do if I'm not immune?

What is rubella?
Rubella, also called German measles, is an infection which can cause a pinkish red rash and flu-like symptoms. If you have rubella, your first symptoms may include:

a mild temperature sore, infected eyes (conjunctivitis) cold-like symptoms, such as a runny nose and sore throat swollen lymph nodes around the back of your neck

A few days later, a red spotty rash will appear on your face and neck, which may feel itchy. The rash will then spread elsewhere on your body. You'll probably have the rash for up to a week before it disappears. However, you may not have any symptoms at all. Up to half of people don't get any symptoms of rubella, so they won't know that they've had it.

If I get rubella during pregnancy will it harm my baby?

Although rubella is a relatively mild illness for you, it's very dangerous for your unborn baby. The risks are highest if you get rubella during your first 11 weeks of pregnancy, when it can lead to miscarriage. A rubella infection during your first three months of pregnancy may also cause your baby to develop congenital rubella syndrome (CRS). This means he could develop: eye defects, such as cataracts (cloudy patches in the eye) damage to his brain, liver, lungs and bone marrow low growth during pregnancy a very small head (microcephaly) heart abnormalities deafness

How will I know if I'm immune to rubella?

If you were vaccinated against rubella, or if you've had it before, you may be immune. However, your immunity to rubella can change over time. So it's a good idea to get your immunity checked before you start trying for a baby. You can do this by asking your GP for a blood test. This is particularly important if you haven't been vaccinated against rubella, or you can't remember having the illness in the past. If you're already pregnant, your GP or midwife will offer you a blood test to check your immunity as part of your antenatal care.

What should I do if I'm not immune?

If you're not immune to rubella you should, if at all possible, be vaccinated before you become pregnant. Then wait one month before trying to conceive. This gives your body enough time to kill off the injected virus so you won't be in danger of passing it on to your baby. If you're already pregnant, you'll need to protect yourself from rubella by staying away from anyone you know who has it. If you think you've been in contact with someone who has rubella, see your GP straight away. You'll have to wait until you've had your baby before you can be vaccinated. This can be done before you are discharged if you have your baby in hospital, or at your postnatal check. If by any chance you were vaccinated in the early weeks of pregnancy before you knew you were pregnant, you have nothing to worry about. There have been no reports of CRS developing in babies under these

circumstances. Your midwife or GP will recommend that you have an ultrasound scan at 18 to 20 weeks to check your baby's health. Read more: http://www.babycentre.co.uk/pregnancy/antenatalhealth/physicalhealth/rubella/#ixzz2A1C8161L

German measles in pregnancy

German measles, or rubella, is a rare and usually mild childhood illness that can cause problems during pregnancy. Here we discuss what to do if you are exposed.
German measles is the common name for rubella. It is a viral infection which causes a reddish-pink rash and a high temperature (over 38C). Rubella is passed on through coughs and sneezes, and is usually only a concern if it is caught by a woman in the first 16 weeks of pregnancy. It is rare in the UK because most people are immunised in childhood. Rubella in pregnancy If you catch German measles early on in pregnancy, the development of your babys heart, brain and eyes may be affected. If caught later in pregnancy, the baby is less at risk although their hearing may be damaged. The birth defects caused by the rubella virus are known as congenital rubella syndrome (CRS). For a pregnant woman who is not already immune, it is important to avoid contact with anyone who has German measles. Congenital rubella syndrome is extremely rare in the UK. However, if you are pregnant and you think you may have been exposed to rubella then contact your GP. They will be able to refer you for tests to see if you have contracted rubella. Immunisation Children are immunised against rubella via the MMR vaccine as part of their routine childhood immunisation programme. The recommendations from the Department of Health, World Health Organisation and British Medical Association are all in favour of vaccination. Further information NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offerantenatal courses which are a great way to find out more about birth, labour and life with a new baby.