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Rubella (German Measles): Causes, Symptoms & Treatment

Rubella, also known as German measles is a type of infection caused by the rubella virus. The infection develops red rashes all over the body, initially on the face from where it will spread throughout the body. It is a contagious [1] disease, and mostly affects children between the age of 5 and 9. In most cases, the symptoms are severely mild that the affected person fails to understand if they are infected.

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The rash develops after two weeks and can last for a period of three days. Itchiness is reported in most cases, however, it is not [2] common to all affected like the swelling of lymph nodes. The swelling can last up to a few weeks, depending on the severity of the condition.

Rubella is commonly spread through the air and the other ways are through coming in contact with an individual who is infected. The infection is typically not very threatening and goes away within a week's time. But in the case of pregnant women, the condition is severe when compared to the others as it can cause miscarriage, bleeding or a child born with the [3] congenital rubella syndrome (CRS) if the woman gets infected during the initial period of pregnancy. After the 20th week of pregnancy, rubella does not pose critical levels of danger to the woman [4] and the foetus.

Symptoms Of Rubella

The mild signs of the infection often go unnoticed, especially in [5] children. The symptoms of rubella appear between two or three weeks after the individual is exposed to the virus. The symptoms can last for a period of three to seven days and include

  • a pink or red rash that begins on the face and spreads to the whole body,
  • runny or stuffy nose[6] ,
  • mild fever with a temperature of 38.9 C (102 F) or lower,
  • red or inflamed eyes,
  • enlarged and tender lymph nodes,
  • a headache,
  • a cough,
  • muscle pain, and
  • joint pain and [7] sore joints (in young women).

Causes Of Rubella

The infection does not have a number of agents but a single one. Rubella or German measles is caused by the rubella virus. The virus is highly [8] contagious and spreads through the air or through close contact. The infection is contagious, that is, it can transfer from one person to the other through coughing or sneezing.

While sneezing or coughing, the drops of fluid from the nose or throat of the infected individual is spread into the air. On inhaling the droplets or by touching the [9] object that has been contaminated by the fluid is enough for one to get contracted by rubella. In the case of pregnant women, the infection can be spread to the foetus through the bloodstream.

An individual with rubella will be contagious for a period of one to two weeks, only after which the red rashes will start developing on the face and then the whole body. So, even before the individual [10] realises that he or she may have contracted rubella, they can act as the transmitters of the infection.

Diagnosis Of Rubella

As the infection poses similarities to other types of infections caused by viruses, German measles or rubella will be diagnosed by your doctor through a [11] blood test. The blood test is carried out so as to examine the possible presence of rubella antibodies in your bloodstream. The antibodies are proteins that can recognize and eradicate the bacteria and viruses. By conducting [12] the blood test, your doctor will be able to tell you if you are immune to the rubella virus and have the virus.

rubella facts

Complications Of Rubella

If you are contracted with the infection, there is a chance that you will become permanently immune to the rubella virus. The infection comes with various complications attached to it.

  • In young girls and women, the rubella virus can cause [13] arthritis in the fingers, wrists and knees. These complications may last for a period of one month or even long term.
  • In some other cases, it can cause otitis media, an ear infection and [14] encephalitis, inflammation of the brain.

Pregnant women are prone to severe complications and risks in the event of rubella infection. It does not really affect the mother, but the unborn child. In some cases, the rubella virus has even resulted in the death of the foetus. When a pregnant [15] woman is affected by the rubella virus, chances of the virus passing down to the child is high.

Reports have revealed that about 80% of babies born to mothers with rubella (during the first 12 weeks of pregnancy) have developed congenital rubella syndrome. The serious health concern can cause [16] stillbirths and miscarriages, and cause the following complications to the newborn:

  • Deafness
  • Growth retardation
  • Defects in internal organs
  • Congenital heart defects
  • Intellectual disabilities
  • Cataracts
  • Liver and spleen damage
  • Thyroid problems
  • Diabetes

Also read: Infections During Pregnancy

Treatment For Rubella

In most cases, the individuals who have been infected have been advised to take plenty of rest. As it is a virus infection, antibiotics are seemingly useless. In [17] children, the disease is mostly very mild and does not require treatment. If the child is suffering from any pain or fever, it is advisable to take children's acetaminophen (Tylenol) or ibuprofen (Motrin).

In the case of pregnant women, it is critical that you go to a doctor immediately. Pregnant women are treated with the [18] hyperimmune globulin antibody that can fight off the rubella virus. However, it does not mean that the unborn child will be freed from the chances of developing congenital rubella syndrome, causing slow foetal growth and retardation.

In the case of others, doctors recommend the individual to stay in isolation from others, especially from pregnant women.

For an infant born with the [19] congenital rubella syndrome, the treatment will vary depending upon the extent of the problem.

Self-care Measures

In the event of an individual being contracted with the rubella virus, it is necessary that the person adopt some lifestyle changes and [20] home remedies.

  • Take plenty of bed rest.
  • Avoid people with a deficient or very low immune system.
  • Inform the people around you (friends, family, co-workers), especially pregnant women so that they can take the necessary preventive methods.
  • Take acetaminophen for the discomfort caused by the fever and body aches.

Prevention Of Rubella

You can protect yourself from being contracted with the infectious virus by looking into the preventive methods. The rubella vaccine, which is given as a combination of [21] measles-mumps-rubella inoculation (MMR), is the most effective as well as the safe vaccine against the infection.

It is medically recommended that children should get the MMR vaccine between 12 and 15 months of age, and one more between 4 and 6 years of age. If in case a [22] child requires the vaccine before 12 months of age, the vaccine can be given when the child is 6 months of age.

View Article References
  1. [1] Gershon, A. A. (2015). Rubella virus (German measles). In Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition) (pp. 1875-1880).
  2. [2] Jablonka, A., Happle, C., Wetzke, M., Dopfer, C., Merkesdal, S., Schmidt, R. E., ... & Solbach, P. (2017). Measles, Rubella and Varicella IgG Seroprevalence in a Large Refugee Cohort in Germany in 2015: A Cross-Sectional Study. Infectious diseases and therapy, 6(4), 487-496.
  3. [3] Centers for Disease Control and Prevention. (2015). Rubella (German measles, three-day measles).
  4. [4] Gupta, S. N., Gupta, N., & Gupta, S. (2015). Modified measles versus rubella versus atypical measles: One and same thing. Journal of family medicine and primary care, 4(4), 566.
  5. [5] Zgorniak-Nowosielska, I., Zawilińska, B., & Szostek, S. (1996). Rubella infection during pregnancy in the 1985–86 epidemic: follow-up after seven years. European journal of epidemiology, 12(3), 303-308.
  6. [6] Makoni, A. C., Chemhuru, M., Bangure, D., Gombe, N. T., & Tshimanga, M. (2015). Rubella outbreak investigation, Gokwe North District, Midlands province, Zimbabwe, 2014-a case control study. Pan African Medical Journal, 22(1).
  7. [7] Chang, C., Ma, H., Liang, W., Hu, P., Mo, X., An, Z., & Zheng, H. (2017). Rubella outbreak and outbreak management in a school setting, China, 2014. Human vaccines & immunotherapeutics, 13(4), 772-775.
  8. [8] Lalwani, C. I. D. S. K., Palkar, S., Mishra, A. C., & Arankalle, V. (2017). Prevalence and Titres of Measles, Mumps, Rubella and Varicella Antibodies in Indian Infants and Toddlers: A Pilot Study.
  9. [9] Otsuki, N., Sakata, M., Saito, K., Okamoto, K., Mori, Y., Hanada, K., & Takeda, M. (2018). Both sphingomyelin and cholesterol in the host cell membrane are essential for Rubella virus entry. Journal of virology, 92(1), e01130-17.
  10. [10] Nazme, N. I., Hussain, M., & Das, A. C. (2015). Congenital Rubella Syndrome-A Major Review and Update. Delta Medical College Journal, 3(2), 89-95.
  11. [11] Vauloup-Fellous, C. (2015). Rubella: Pitfalls in the diagnosis and the determination of the immune status. Journal of Clinical Virology, 70, S11.
  12. [12] Mahmood, T. A., Sultan, B. A., Mohammed, S. N., & AL-Hucheimi, S. N. (2015). Serological and Molecular Diagnosis of Rubella virus and Cytomegalovirus in aborted Patients in Al-Najaf province. kufa Journal for Nursing sciences, 5(2), 99-105.
  13. [13] Bechar, M., Davidovich, S., Goldhammer, G., Machtey, I., & Gadoth, N. (1982). Neurological complications following rubella infection. Journal of neurology, 226(4), 283-287.
  14. [14] Phelan, P., & Campbell, P. (1969). Pulmonary complications of rubella embryopathy. The Journal of pediatrics, 75(2), 202-212.
  15. [15] Uyar, Y., Balci, A., Akcali, A., & Cabar, C. (2008). Prevalence of rubella and cytomegalovirus antibodies among pregnant women in northern Turkey. New Microbiol, 31(4), 451-455.
  16. [16] Fomda, B. A., Thokar, M. A., Farooq, U., & Sheikh, A. (2004). Seroprevalence of rubella in pregnant women in Kashmir. Indian journal of pathology & microbiology, 47(3), 435-437.
  17. [17] Nofal, A., & Nofal, E. (2010). Intralesional immunotherapy of common warts: successful treatment with mumps, measles and rubella vaccine. Journal of the European Academy of Dermatology and Venereology, 24(10), 1166-1170.
  18. [18] Lundstrom, R. (1962). Rubella during pregnancy. A follow-up study of children born after an epidemic of rubella in Sweden, 1951, with additional investigations on prophylaxis and treatment of maternal rubella. Acta paediatrica. Supplementum, 133, 1-110.
  19. [19] Rawls, W. E., & Melnick, J. L. (1966). Rubella virus carrier cultures derived from congenitally infected infants. Journal of Experimental Medicine, 123(5), 795-816.
  20. [20] García, J. A. O., Angulo, M. G., Sobrino-Najul, E. J., Soldin, O. P., Mira, A. P., Martínez-Salcedo, E., & Claudio, L. (2011). Prenatal exposure of a girl with autism spectrum disorder to'horsetail'(Equisetum arvense) herbal remedy and alcohol: a case report. Journal of medical case reports, 5(1), 129.
  21. [21] Centers for Disease Control (CDC. (1984). Rubella prevention. MMWR. Morbidity and mortality weekly report, 33(22), 301.
  22. [22] Zimmerman, L. A., Reef, S. E., & Orenstein, W. A. (2018). Rubella Vaccine—A Tale of Appropriate Caution and Remarkable Success. JAMA pediatrics, 172(1), 95-96.

Story first published: Thursday, January 3, 2019, 17:40 [IST]
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