Rubella: Causes, Symptoms & Treatment

A well-known childhood disease is rubella. Characteristic of this viral disease are mainly swollen lymph nodes and the typical skin rash.

What is rubella?

A disease that many people encounter in the course of life are rubella. Rubella is a viral disease and mostly occurs in childhood. Typical for the disease are mainly a very strong skin rash, swollen lymph nodes and also a strong fever. In most cases, however, the affected persons are lucky and the disease runs without symptoms, so that it is often not even noticed and remains undetected. Rubella, however, is considered a highly contagious disease, which should be taken seriously. The causative viruses are usually transmitted by droplet infection, such as coughing or sneezing. Almost never serious complications occur with rubella disease, unless the rubella disease occurs during pregnancy. In pregnancy, rubella disease can have serious consequences. For example, there may be dangers for the unborn child. For example, it can happen that the organs of the embryo are affected. In these cases, termination of pregnancy for medical reasons is also an option that is often considered. Therefore, it is recommended in any case, especially for girls, to vaccinate against rubella until puberty.

Causes

The causes of rubella are clear. A rubella disease is always based on an infection with a virus. In this case, it is the so-called rubivirus. The rubivirus belongs to the grouping of togaviruses. The ruby virus has RNA as its genetic material and is spread all over the world. However, after a single rubella infection, humans are immune to the virus and have already formed antibodies against a new infection, which are reactivated to defend the body upon contact with the virus. The incubation period (the time from infection to outbreak) of the disease is about two to three weeks in most cases. The incubation period varies from person to person. Often the transmission occurs through sneezing or coughing, but also an infection through kissing or by sharing dishes or cutlery is not excluded. The probability that the disease or the virus is transmitted from an already infected person to another is 20% to 70%.

Symptoms, complaints, and signs

Rubella manifests itself through the typical symptoms of a cold. These include a cold, cough, mild headache, and occasionally conjunctivitis. In many cases, the disease resolves after these symptoms, with no further symptoms. Half of the patients experience swelling of the lymph nodes in the neck and throat. The lymph nodes behind the ears can cause severe pain, often associated with unpleasant itching. A few days after the swelling, the typical rubella rash finally appears. Then small reddish or brownish spots form behind the ears, which within a short time spread to the entire face as well as neck, arms and legs. As it progresses, the entire body is affected. The rash usually resolves quickly if the patient seeks treatment. After two to three days, the spots usually subside. In children, the disease may last longer. In addition, accompanying symptoms such as fever and malaise may develop. Rubella regresses a few days after infection with the pathogen and, apart from a feeling of illness, usually does not cause any other signs of illness.

Course of the disease

The course of rubella is usually positive without further complications. Especially in children, there are usually no serious symptoms and no significant discomfort is evident. Those who have already had the disease are immune to it and need not worry about a recurrence. After the initial infection, immunity is lifelong. A repeated infection can only occur under certain circumstances. For example, the disease can reoccur if the affected person has a low number of antibodies, i.e. an immune deficiency. If such a reinfection occurs, however, the symptoms are very attenuated and not particularly noteworthy.The symptoms are usually mild or do not become apparent at all. The course of the disease in these cases is even more rapid than in the case of an initial infection.

Complications

Complications are only to be feared in rare cases of rubella disease. This primarily affects adult patients, while children suffer from it only occasionally. The higher the age of the patient, the greater the risk of sequelae. The most common complications of rubella include inflammation of the joints and arthritis. Occasionally, the amount of platelets in the body also decreases, resulting in a more frequent risk of bleeding. Rarely, encephalitis (inflammation of the brain), inflammation of the ears (otitis), inflammation of the pericardium (pericarditis), inflammation of the heart muscle (myocarditis), or minor vascular impairments that cause bleeding under the skin also occur. Other sequelae of rubella infection include bronchitis, epilepsy, hepatosplenomegaly (enlargement of the liver and spleen), and thrombocytopenic purpura. Rubella complications are considered dangerous especially during pregnancy. Thus, there is a risk that the sick mother will also infect her unborn child, which occurs through the placenta. This has a negative effect on the development of the baby, because there is a risk of severe malformations of the organs. Among the conceivable sequelae are deafness, malformations of the eyes or heart such as unclosed heart walls, as well as mental impairments. In addition, there is a risk of rubella causing premature birth or miscarriage. If rubella occurs during pregnancy, the affected pregnant woman may choose to have an abortion.

When should you see a doctor?

If rubella is suspected, a doctor is needed as soon as possible. Although the disease usually has no complications in children, diagnosis and clarification about the need for medical care are indicated. The children’s disease is considered highly contagious and can be dangerous for the unborn child, especially in pregnant women. In severe cases, there is a miscarriage or lifelong health damage to the offspring. Changes in the skin and swollen lymph nodes are characteristic of the disease. In addition, there is coughing as well as a strong development of fever. A visit to the doctor is already advisable at the first irregularities, since the pathogens spread within a short time and lead to a deterioration of health. Faintness, fatigue and a general feeling of illness are signs that should be presented to a doctor. In case of itching, pustules as well as open wounds, medical care is necessary. If swelling, profuse perspiration and increased fatigue occur, a physician should be consulted. Behavioral abnormalities, an inner restlessness as well as headaches should be examined and treated. Especially adults who do not have sufficient vaccination protection against rubella should consult a doctor if the symptoms increase. There is a risk of secondary diseases that can lead to lifelong impairment.

Treatment and therapy

Treatment for rubella is not necessary in most cases and aims only to relieve the symptoms of the disease in the short term. If symptoms such as fever occur, antipyretic medications are prescribed. Also, in some cases, anti-inflammatories may be prescribed. Antihistamatics are also often used in the treatment of rubella. However, bed rest is usually sufficient to allow the disease to slowly subside.

Aftercare

Rubella resolves within a few days with appropriate treatment. After recovery, the doctor must conduct a follow-up examination and check the patient’s health. As part of the follow-up, a physical examination and a patient interview take place. The physical check-up includes a visual diagnosis, a fever measurement and other measures depending on the severity of the disease. The discussion with the patient serves to clarify open questions and ambiguities. The physician will obtain information about the course of the rubella and, if necessary, also inquire about the effectiveness of the prescribed antibiotics. In case of side effects, a change of medication is necessary, which must be phased out after recovery.He or she will give the parent or guardian further advice and, if necessary, can put the child in touch with a specialist if the rubella does not subside or other problems arise. Rubella follow-up is performed by the pediatrician or family doctor. The final examination takes place a few days after recovery. Provided no abnormalities are found, the patient is discharged. No further examinations are necessary.

What you can do yourself

If the child suffers from rubella, bed rest applies. Often the viral disease occurs without physical symptoms, but physical rest is still important. The child should also be isolated until the rash has subsided. This will prevent infection. If necessary, the kindergarten or school must be informed about the illness. Other parents then have the opportunity to have their child examined and have any rubella detected at an early stage. Newly pregnant women who have not yet contracted rubella should see the doctor if the child has rubella. The child is best placed with friends or relatives. In addition, various home remedies help against rubella. For example, calf compresses or vinegar socks have proven effective, as well as cooling and the use of gentle baths. Quark compresses and cooling compresses help with aching lymph nodes. If the symptoms do not subside despite all measures, the pediatrician should be consulted. If the course is positive, the child should take it easy for at least one to two weeks. Physical activity contributes to a rapid recovery from the second week. In children, early vaccination against the pathogens is recommended to prevent rubella from occurring in the first place.