Clinical Reference Systems: Pediatric Advisor 10.0
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Rubella (German Measles)

DESCRIPTION (Diagnosis must be confirmed by a physician.)

A rash of widespread pink-red spots starts on the face and moves rapidly downward, covering the body in 24 hours.
The rash lasts 3 to 4 days ("3-day measles").
The lymph nodes at the back of the neck are enlarged.
Your child has a mild fever.
Your child never had the rubella vaccine.

The rash is not distinctive. Many other viral rashes look like it. Physicians have difficulty being certain of this diagnosis even after examining the child. This diagnosis usually can't be made unless there is an epidemic of it in your community.

CAUSE

Rubella is caused by a virus. The incubation period (time between exposure to someone with the disease and the beginning of symptoms) is 14 to 21 days.

EXPECTED COURSE

The disease is mild. Your child should be completely recovered in 3 or 4 days. Complications in general are very rare. However, pregnant women should avoid anyone who may have rubella. Complications to the unborn child of a pregnant woman with rubella are disastrous and include deafness, cataracts, heart defects, growth retardation, and encephalitis.

HOME CARE

If your physician has determined that your child probably has rubella, the following may be helpful:

  1. Treatment

    No treatment is usually necessary. Give acetaminophen or ibuprofen for fever over 102 degrees F (38.9 degrees C), sore throat, or other pains.

  2. Avoid pregnant women

    If your child might have rubella, keep him away from any pregnant women. He is contagious for 5 days after the start of the rash.

  3. Exposure of adult women to rubella

    A nonpregnant woman exposed to rubella should avoid getting pregnant during the next 3 months.

    A pregnant woman exposed to rubella should see her obstetrician. If she has already received the rubella vaccine, she and her unborn child are probably protected. Even if she thinks she had German measles as a child and the recent exposure was minor or brief, she should have a blood test to determine her immunity against rubella.

  4. Rubella vaccine

    Get your children immunized against rubella at 12 to 15 months of age so we won't have to worry about pregnant women getting exposed to rubella when a child gets a pink or red rash. It's safe to immunize a child who has a pregnant mother.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

The rash becomes purple spots or dots.
Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

The rash becomes itchy.
The fever lasts more than 3 days.
You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems