Rubella in adults – What are the special features? | Rubella

Rubella in adults – What are the special features?

Since rubella is a typical childhood disease, it is very rare in adults. However, unvaccinated adults are just as susceptible to infection as children. A special danger exists for the unborn children of non-vaccinated pregnant women who are infected with rubella.

Rubella in adults, like in children, is also rather unspecific. The first symptoms are classic colds such as a cold, headaches, aching limbs and slightly raised temperatures. In half of the cases, the rubella infection has thus already subsided.

The other half of those affected get other symptoms in addition, such as a swelling of the lymph nodes or the typical fine spotted rash that spreads from the head (usually behind the ears) to the body. Certain complications occur more frequently in adults than in children. However, these are still very rare overall.

These include joint pain (arthralgia) and inflammation of the joints (arthritis), which can also be observed in older children. In addition, there are cases in which there is an invasion of the lower respiratory tract in the sense of bronchitis. A spread to the brain (encephalitis) and to the pericardium or heart muscle is also possible.

Diagnosis

The clinical symptoms are often not characteristic of rubella disease. Since the virus itself is difficult to detect, rubella antibody detection is performed: If IgM antibodies (see: immune system) against the rubella virus are present in the blood, this indicates a current rubella infection, but is not conclusive, since the IgM antibody concentration can also be increased by other viral diseases or may still be elevated for a long time after a past and subsided infection (up to one year after the rubella disease). To confirm or rule out rubella disease, two blood samples should be taken at 14-day intervals and a test for IgG antibody against rubella should be performed.

This procedure is mainly used during pregnancy: If rubella infection of the unborn child is suspected, two blood samples should be taken to determine the IgG concentration (=IgG titer determination). If the determined values show that the mother is immune to the virus, the infection of the unborn child is ruled out. An invasive method is required to detect rubella infection in the child: amniotic fluid puncture and tests or a fetal blood sample taken from the mother’s womb can be used to detect the presence of nucleic acid (genetic material of the virus) in the child.