Pediatric Rubella

Rubella is a viral illness that causes a mild fever and a skin rash. It's also called German measles, but is not caused by the same virus that causes measles (rubeola). Rubella is spread through contact with fluid from the nose and throat. It can be prevented with a vaccine.

Babies and children who get rubella usually only have a mild case of the rash and some respiratory symptoms. But it can be a dangerous infection for a baby in the womb. It can lead to miscarriage or birth defects.

Rubella is caused by a virus. The virus spreads through fluid from the nose and throat of an infected person. It can also be spread from a pregnant mother to her unborn baby. A child born with rubella is considered to be contagious until age one. Rubella infections are most common in late winter and early spring.

A child is more at risk for rubella if he or she is around a person with rubella and has not had the vaccine.

It may take 14 to 21 days for a child to have signs of rubella after contact with the virus. Symptoms can occur a bit differently in each child. The most common symptoms start with:

• A period of not feeling well
• Low fever
• Runny nose
• Diarrhea

These symptoms may last 1 to 5 days. Then a rash appears.

The rash:

• Starts on the face as a pink rash with areas of small raised lesions
• Spreads down to the torso, arms and legs as the face rash clears up
• Fades in 3 to 5 days

Your child may also have enlarged lymph nodes in the neck. An older child may have sore, inflamed joints.

A child is most contagious when the rash is appearing. But a child may be contagious from 7 days before the rash to 7 days after the rash has started. Because of this, a child may pass the virus to others before you know he or she is sick.

The symptoms of rubella can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. The unique rash may be enough to diagnose your child. He or she may also have blood or urine tests to confirm the diagnosis.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

The goal of treatment is to help ease symptoms. Treatment may include:

• Lots of rest
• Making sure your child drinks plenty of fluids

The infection will go away on its own in 5 to 10 days.

Rubella is dangerous to a baby in the womb. It can cause a pregnant woman to have a miscarriage. A baby in the womb can also get rubella from his or her mother during pregnancy. This can lead to severe birth defects known as congenital rubella syndrome. Signs of congenital rubella syndrome can include:

• Cataracts in the eyes
• Deafness
• Heart problems
• Learning problems
• Growth delays
• Enlarged liver and spleen
• Skin lesions
• Bleeding problems

Rubella can be prevented with the rubella vaccine. The rubella vaccine is often given as part of a combination vaccine. The vaccine includes protection against measles, mumps and rubella (MMR). The vaccine is usually first given when a child is age 12 to 15 months, and then again between ages 4 and 6. Make sure that your child's friends and caregivers have had the MMR vaccine. In addition, girls should have completed the MMR vaccine before they reach child-bearing age.

If your child has rubella, you can help prevent the spread of the virus. Make sure to keep your child home from school and play dates for 7 days after the start of the rash. Talk with your child’s healthcare provider for more guidance. Note that a child born with rubella is considered to be contagious until age one.

Call the healthcare provider if your child has:

• Symptoms that don’t get better, or get worse
• New symptoms