Rubella is a highly infectious virus that commonly affects children. It is also known as German measles. Rubella infection usually results in a mild illness for most people. However, if pregnant women are infected, especially in the first 20 weeks of pregnancy, it can cause birth defects. The virus damages the developing heart, brain, eyes and ears of the foetus. This condition is called congenital rubella syndrome. The best protection against rubella is vaccination.

 

How It Spreads

The rubella virus is spread through the air or by close contact when the infected person coughs, sneezes or touches a surface. You or your child may contract the virus by breathing in or touching the infected droplets, and then touching your eyes, mouth or nose.
 
A mother with an active infection can also transmit rubella to her foetus.
 

Signs and Symptoms of Rubella

It’s hard to tell if someone has an active rubella infection.
 
In children: A child with rubella may not look or act sick. However, they might demonstrate one or some of these symptoms:
  • A low-grade fever and swollen glands behind the ears, and at the back and sides of the neck.
  • Loss of appetite, irritability, loss of interest in personal care.
  • Rash, which appears in only about half the cases of rubella. When it does appear, it starts on the face and torso, and spreads to the arms and legs. The rash can last from 3 to 5 days.
In adults: Adults generally experience warning symptoms such as a fever, headache, malaise, runny nose, and inflamed eyes. This can last from 1 to 5 days before the rash appears.
 

Contagiousness

A child or adult can easily spread the virus 1 week before any rash appears, and without showing any symptoms. This infectious period lasts until 1 week after the rash disappears.
 
Once a person gets infected with the rubella virus, he has lifelong immunity to the disease.
 

Complications

  • Congenital Rubella Syndrome: Rubella becomes potentially serious when a woman is infected early in her pregnancy. This is because the virus can produce defects in the developing foetus.

If a mother contracts rubella in the first trimester of her pregnancy, there is a 25% chance of the baby being born with congenital rubella syndrome. Some of the defects include deafness, cataracts, microcephaly, mental retardation, and congenital heart defects. However, defects are rare if the infection occurs after the 20th week of pregnancy.

If a woman is unvaccinated, she may experience: 

  • miscarriage or stillbirth
  • sore, swollen joints, and arthritis in the knees, wrists and fingers.
Children who are infected with rubella, may face complications such as:
  • brain infection called encephalitis, a rare but serious complication.
 

Treatment and Confinement

To minimise the spread of the infection, you or your child should stay at home. Be sure to avoid any close contact with people for as long as you show any signs of the infection. If there is a rash, remember that you are still infectious up to a week after the rash disappears.
 
You or your child do not need any conventional medical treatment.
 
If you are pregnant, you should contact your doctor immediately. The risk of birth defects is higher the earlier the exposure occurs in your pregnancy. In some cases, your doctor may advise you to consider a therapeutic termination of your pregnancy.
 

Care at Home

If your child has a fever, treat it as you normally would, such as ensuring your child gets plenty of fluids and rest. Cool sponging will help relieve the discomfort from the rash. You can give your child medication such as paracetamol to reduce the pain and fever. However consult your doctor before giving any fever-reducing medicine for the first time. Rubella is a viral infection so antibiotics will not be prescribed because they do not work on viral illnesses.

Remember to keep your child at home while any rash is visible, as well as for a week after the rash subsides to prevent the spread of Rubella virus to others.

 

Prevention

In Singapore, two doses of the MMR or MMRV vaccine are recommended for children. The MMR (measles, mumps, and rubella vaccine) or the MMRV (measles, mumps, rubella and varicella vaccine) is given at 12 months and 15-18 months old.

At least three months before trying to become pregnant, a woman should have a blood test to see if the rubella antibodies are present; if not, she should be immunised or re-immunised with a measles vaccine.

Rubella vaccines are safe and have been used for many years to protect children and pregnant women against infection. They are about 97% effective at preventing rubella infection.

Click here for more information on subsidies available, other vaccine-preventable diseases and frequently asked questions.

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