In children, rubella usually runs a harmless course. Often they are not even noticed because they do not show any noticeable symptoms. For pregnant women and their unborn babies, however, they can become a serious danger. Rubella is a classic childhood disease and, like measles and chickenpox, is caused by viruses; however, it is not quite as contagious. They are transmitted by droplet infection when sneezing, coughing or talking. However, 14-21 days pass before the disease breaks out. However, those affected are also contagious one week before and one week after the onset of the rashes. In about half of childhood infections, the disease goes unnoticed because there are no noticeable symptoms.
What are the symptoms?
Usually, the disease begins with cold-like symptoms such as cough and runny nose, possibly conjunctivitis. The lymph nodes in the neck swell and hurt. One to two days later, the bright red, fine-spotted rash appears behind the ears and then spreads over the face, neck, arms and legs to the entire body.
Children may have a slight fever, rarely itching; however, they usually feel little ill. The rash disappears after two to three days. After infection, a person is immune for life.
How does the doctor make the diagnosis?
The doctor tries to make his diagnosis based on the external appearance of the child. This is not always easy, because rubella can be very easily confused at first with other childhood diseases, such as scarlet fever or measles.
How is it treated?
There is no specific therapy. Only the symptoms that occur are treated.
Complications
Rare complications, but more common with age, include inflammation of the ear, brain, and joints. Rubella is particularly feared during pregnancy: infection of the mother transmitted through the placenta (placenta) causes severe damage to the unborn child (heart defects, deafness, blindness, mental retardation) and can cause premature birth or miscarriage. Frequency and severity depend on the time of infection during pregnancy. The risk is greatest during the first four months of pregnancy.
Important
- A sick child should not come into contact with pregnant women who have not had rubella or who have not been vaccinated.
- Women of childbearing potential should have a blood test for antibodies to rubella viruses at their doctor’s office and be vaccinated if they are not protected.
Pregnant women and rubella
If a (unvaccinated) pregnant woman has contact with an infected person or suspects that she has already been infected, a blood test should be performed immediately. If she has indeed become infected, a special antibody preparation must be given as soon as possible.
In addition, it can be examined whether the fetus has been infected. This is done via a chorionic biopsy (tissue removal from the placenta) or an amniocentesis; from the 22nd week of pregnancy, the umbilical cord blood of the fetus can also be tested. These tests can only be performed by experienced experts.
Preventive measures
Effective protection is provided by vaccination in infancy, for both girls and boys. In Germany (FRG), rubella vaccination was introduced in 1974. It has been recommended since 1980 by the STIKO (Standing Commission on Vaccination at the Robert Koch Institute) as a combination vaccination with measles and mumps (MMR vaccination).
It is usually given between the 12th and 15th month of life and a second time in the 2nd year of life, at the earliest 4 weeks after the first. This second vaccination is not a booster vaccination, but is intended to give a second chance to those vaccinated for whom the first vaccination did not “hit” properly. If a child is scheduled for admission to a child care facility, the MMR vaccination can also be given beginning at 9 months of age.
Important
Since there is no age limit, the vaccination can be made up at any age. In addition, MMR vaccination is recommended in antenatal and postnatal care facilities and in infant and child care settings.
