Pathogen

The causative agent of rubella is the rubella virus. It is an RNA virus from the genus Togaviridae. The rubella virus occurs only in humans. The human is therefore the only host. Like the measles, mumps or chickenpox virus, the rubella virus causes a typical childhood disease.

Symptoms

Before the appearance of the rash (=exanthema), flu-like symptoms such as fever, limb and headaches or sensitivity to light are possible. The rash is light red and small spots, but the individual skin symptoms do not merge into each other (=non-confluent exanthema). It usually starts behind the ears and spreads from the ears over the trunk, arms and legs.

The body temperature is only moderately increased during the course of the disease, if at all. Elderly patients suffering from rubella, i.e. adolescents and adults, are often affected by a temporary joint inflammation (= arthritis) with painful movement restrictions. In most cases, the rubella patient recovers within a few days after the appearance of the exanthema.

Rubella in babies – What are the special features?

The newborn has a certain nest protection against rubella in the first weeks of life by the antibodies of the mother, in case if the mother had a rubella disease in childhood or received the two rubella vaccinations. However, this protection quickly fades away so that the two rubella vaccinations are more than recommended. Initially, the rubella infection proceeds in the same way as in older children.

There is a slight impairment of the general condition. The baby is limp and the drinking behaviour is usually reduced. The nose runs and the eyes are often reddened in the sense of conjunctivitis.

In addition, there are other unspecific complaints such as headaches, aching limbs and swelling of the lymph nodes in the neck and behind the ears.The temperature can rise to a maximum of 38°C, in some cases even higher. A few days after this unspecific feeling of illness the typical rash appears. It is characterized by light red, easily distinguishable, small to medium spots.

First they can be seen behind the ears or on the head and then spread to the trunk of the body as well as arms and legs. Within three days, however, the rash has already disappeared again. Rubella embryopathy or rubella fetopathy is a special condition in babies:

In rubella embryopathy, infection occurs during the first third of pregnancy when the mother develops rubella if she is not adequately protected and the unborn child is affected.
At the beginning of pregnancy complications occur even in up to 90% of cases. Frequently, the pregnancy is aborted, a mental disability or the so-called Gregg triad occurs. This consists of inner ear deafness, cataracts and various heart defects.

The degree of severity varies depending on the week of pregnancy in which the infection occurred.
In rubella fetopathy, the infection occurs after the first trimester of pregnancy. In this case, the baby may develop an inflammation of the liver (hepatitis) or an enlargement of the spleen (splenomegaly). Changes in the blood count, such as anemia (hemolytic anemia) or a drop in platelets (thrombocytopenia) are also possible.