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Rubella Symptoms, Treatment, Causes, and Diagnosis

Jul 19, 2023


Rubella is a widespread viral infection best recognized for its characteristic red rash. Rubella is also known as three-day measles or  German measles. Most persons suffering from rubella may only experience minor symptoms or no symptoms at all. But it can lead to serious complications if it affects pregnant women.

Rubella is not the same as measles, but the two diseases do have similar signs and symptoms, such as the red rash. Rubella is not as contagious or dangerous as measles and is brought on by a separate virus.

Read this blog further to get a quick overview of this important topic for PEDIATRICS  to ace your NEET PG exam preparation.

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Causes Of Rubella

The rubella virus is very contagious and can spread by airborne contact or close touch. It can spread from person to person when tiny drops of mucus from the throat and nose come in contact with each other when sneezing and coughing. 

This means that you can contract the virus by contacting an object that has been contaminated with the droplets of an infected individual or by inhaling their droplets. The bloodstream is another route by which a pregnant lady can spread German measles to her unborn child.

German measles patients are most infectious during the week before the rash emerges and for around two weeks after the rash has disappeared. Even before individuals realize they have the infection, they can spread it.

Rubella Symptoms

It might be difficult to identify rubella symptoms and warning signs, especially in young children. Generally speaking, two to three weeks after a virus is introduced, signs and symptoms start to appear. They usually last one to five days and might consist of:

  • Mild fever, 102 F (38.9 C), or below
  • Pink rash that starts on the face, spreads quickly to the trunk, then the arms and legs, and then disappears in the same way. Headache, runny or stuffy nose,
  • Itching, big red eyes,
  • Painful lymph nodes at the back of the neck, behind the ears, and at the base of the skull.
  • Pain in joints especially in young women

How Does Rubella Affect In Pregnancy?

Rubella poses a serious risk to a pregnant mother and her unborn child. Anyone who has not received the rubella vaccination is at risk of contracting the illness. Before becoming pregnant, women should make sure they are rubella-free.

The first 12 weeks (first trimester) of pregnancy are when the mother is most severely harmed by rubella virus infection. In the United States, 15 infants with CRS were documented from 2005 to 2018.

Congenital Rubella Syndrome

A developing baby in the womb of a woman who has the rubella virus can develop congenital rubella syndrome (CRS), a disease. Rubella can cause miscarriage or stillbirth in pregnant women and it can also lead to serious birth abnormalities in growing children. Nearly every system in a developing baby's body can be impacted by CRS.

Birth abnormalities caused most frequently by CRS can include:

  • Deafness
  • Cataracts
  • Heart issues
  • Cognitive impairments
  • Spleen and liver damage
  • A light birth weight
  • Newborn skin rash

Less frequent CRS problems can be:

  • Glaucoma
  • Damaged brain
  • Hormone issues, including thyroid issues
  • The lungs being inflamed


Diagnosis of congenital rubella syndrome can be made with the help of the following:

  1. Hemagglutination inhibition test - Mostly preferred
  2. ELISA test helps in the Detection of IgG. These IgG antibodies represent previous or past infection. IgM means represent recent infection
  3. Demonstration of rise in antibody title between 2 serum samples taken 10 days apart or rubella-specific IgM in a single sample accurately confirms recent infection
  4. Virus isolation

Blueberry Muffin Rash

Blueberry Muffin Rash

It is Seen in cytomegalovirus and rubella. Noninfective causes of blueberry muffin rash are:

  • Congenital spherocytosis, 
  • Rhesus hemolytic disease
  • ABO blood group incompatibility
  • Anemia caused by twin-to-twin transfusion.

Blueberry Muffin Syndrome 

Blueberry muffin syndrome is a rare neonatal skin disorder characterized by Widespread non-blanchable and Maculo papular lesions of reddish-blue or magenta color. It occurs due to persistent dermal erythropoiesis in patients with congenital viral infections. It goes away with time.

 Forchheimer Spot

 Forchheimer Spot

Discrete rose-colored spots on the soft palate coalesce into red blush and extend over fauses. These spots are found in rubella but these are Nonspecific

Treatment of Congenital Rubella Syndrome

Although individual symptoms can be managed, CRS cannot be cured.

Since there is no treatment, it is crucial that women receive a vaccination before becoming pregnant.

Recommended Vaccinations
In order to ensure that they are immunized before to becoming pregnant, women who intend to become pregnant should consult their doctor.

For at least four weeks after receiving the MMR vaccine, adult women of reproductive age should abstain from becoming pregnant.

MMR vaccination is not recommended for pregnant women.

If you contract rubella while pregnant or are exposed to it, call your doctor right once.

Complications Of Rubella

The condition known as rubella is not severe. In  Rubella patients occasionally there is development of arthritis in fingers, wrists, and knees, which lasts for about a month. In rare instances, rubella might lead to an ear infection or brain inflammation.

Rubella can have serious, even deadly, effects on an unborn child if you are pregnant at the time of infection. Congenital rubella syndrome can occur in up to 90% of babies born to women who had rubella within the first 12 weeks of their pregnancy. The following issues may result from this syndrome:

  • Delays in growth
  • Cataracts
  • Deafness
  • Issues with heart development (congenital heart defects)
  • Issues with the other organs' development
  • Issues with learning and mental development
  • A very high risk to the fetus if the infection occurs during the first trimester however exposure in later trimesters is also dangerous.

Prevention Of Rubella

Rubella vaccine: 

  • Strain: RA 27/3
  • Type: Live vaccine
  • Dose: 0.5 ml
  • Route: Subcutaneous route
  • Recipients were advised not to become pregnant over the next 1 month. 
  • Available in combined vaccine with MMRV (measles, mumps, rubella, varicella), MR

Rubella Vaccination Strategy

  • It is divided into three priorities:
    • 1st priority: Women of reproductive age group (non-pregnant women)
    • 2nd priority: Interrupt the transmission by vaccinating children between 1-14 years of age
    • 3rd priority: Routine vaccination of children who are < 1 year of age

Treatment Of Rubella

The duration of the rubella infection cannot be shortened by treatment, and because the symptoms are frequently minor, no treatment is usually necessary. However, during the contagious period, medical professionals typically advise seclusion from others, particularly pregnant women. 

The management of a child with congenital rubella syndrome varies according to the severity of the infection of the child. Children with various difficulties could benefit from early care from a specialized team.

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