5 Symptoms Of Rubella In Children, Treatment And Prevention

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The rubella virus causes a contagious viral infection known as rubella. While rubella in children is usually a mild condition, it can cause major complications in unborn babies if their mothers contract it during pregnancy.

It spreads through droplets or direct contact with an infected person’s saliva or mucus and is also known as German measles or three-day measles. Rubella causes a red rash all over the body, one of the most noticeable signs.

Read on to learn about the signs and symptoms of rubella in kids as well as treatment options and preventative strategies.

Symptoms Of Rubella

The symptoms of pediatric rubella infection are usually mild; the rash appears two to three weeks after exposure to the virus. According to the World Health Organization (WHO), this rash is observed in approximately 50 to 80 percent of affected children and typically endures for one to three days. Some common symptoms of rubella in children include (1) (2):

1. Red-colored spotty rash that start on the face and neck and progress downward (rashes last for one to three days)

2. Swollen lymph glands behind the ears and in the neck

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3. Low fever with a body temperature of less than 39℃

4. Nausea and mild conjunctivitisⁱXInflammation of the transparent membrane that covers the inner region of eyelids and the outer part of the eyeball

5. Soreness and inflammation of joints (more common in older children and adolescents)

Once a child is infected, the virus spreads through the body in five to seven days. The child may spread the virus one week before the onset of rash and remain contagious up to seven days after the rash appears. However, the Centers for Disease Control and Prevention states that 25% to 50% of people do not develop a rash or any symptoms (3).

A woman infected with rubella during early pregnancy (before 10 weeks are completed) has a 90% chance of passing the virus to the fetus. The virus may cause a miscarriage, or the fetus may develop congenital rubella syndrome (CRS) (1). Anyone with rubella or exposure to a known case of rubella should not come in direct contact with a pregnant woman.

Things to know

Thrombocytic purpura (tiny spots on the skin) and encephalitis (brain infection) are rare complications of rubella in children (12).

Congenital Rubella Syndrome

Babies born with CRS suffer from many congenital disabilities.  Some common disabilities associated with this congenital syndrome include the classical triad of cataract, heart defects, and deafness. The following are usually seen in neonatal period and are transient (1) (2) (4):

• Low birth weight

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• Low platelets
• Anemia
• Enlargement of liver and spleen
• Inflammation of brain and meningesⁱXTri-layered membranes that protect the central nervous system (the brain and spinal cord)

Longer lasting or permanent manifestations include:

• Hearing impairments
• Eye defects such as cataract, glaucomaⁱXAn eye condition where optic nerves are damaged due to increased pressure on the eyes, leading to gradual vision loss , retinal damage, small eye
• Heart defects such as patent ductus arteriosusⁱXA congenital condition in which the opening between two crucial blood vessels of the heart fails to close and pulmonary hypertension
• Autism
• Diabetes mellitusⁱXA metabolic disease characterized by high sugar levels in the blood
• Thyroid dysfunction
• Mental retardation
• Delayed growth

As some of these impairments are lifelong and require therapies and surgeries, women of childbearing age are advised to take the measles mumps rubella (MMR) vaccination. However, it is not advisable to vaccinate pregnant women. The vaccine should be taken at least four weeks before planning a pregnancy.

Who Is At A Higher Risk For Rubella?

Anyone who does not have immunity against rubella is at risk of developing rubella. However, according to the World Health Organization (WHO), the highest risk of CRS is in women of childbearing age who do not have immunity to the disease (1).

Diagnosis And Treatment For Rubella

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Your child’s doctor might diagnose rubella based on physical examination and the child’s medical history. The pediatric specialist might further recommend blood or urine tests to confirm the diagnosis (5).

Since rubella is a viral infection, there is no cure for it. It is best to vaccinate children and women in child bearing age beforehand. If your child is infected with the rubella virus, your doctor might recommend the following.

• Increased intake of fluids
• Adequate rest
• Isolation to prevent the spread of the virus
• Over-the-counter medications to reduce the severity of the symptoms (5)

Children might recover from rubella within a week.

The caretaker should always wash and disinfect the infected child’s clothes and dry them under the sun. It is important to teach children to cover their nose and mouth when sneezing or coughing. Such precautions should be taken to prevent the spread of the infection.

Prevention Of Rubella

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The best way to prevent the infection is through vaccination. The vaccine for rubella is a live attenuated strain, and a single dose can give long-lasting immunity to more than 95% of children (6). The vaccine is available in monovalent (single vaccine for rubella) form and is also administered in combination with other vaccines, such as the measles, mumps, and rubella (MMR) vaccine. However, in rare cases, children can get rubella even if they had been vaccinated or had a previous rubella infection (7).

According to the CDC, all children should get two doses of the MMR vaccine. The first dose should be given at 12–15 months of age, and the second dose at 4–6 years of age. Children can also receive the second dose 28 days after the first dose (8). In India, the first dose is given at 9 months and second at 15 months. It has recently been added to the national immunization schedule and is to be given in combination with measles vaccine.

Quick fact

In places with a temperate climate, rubella infections generally occur during late winter and early spring (12).

Possible Side Effects Of The Vaccine

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There may be mild adverse reactions after the vaccination, including pain and redness at the injection area, low-grade fever, rash, and muscle aches (1).

However, children with the following conditions should consider vaccination only after consulting a doctor (8).

• Children with life-threatening allergies and a weak immune system due to HIV or cancer and children undergoing medical treatments such as radiation, immunotherapy, steroids, or chemotherapy

• Children with a family history of immune system problems

• Children who had a condition that makes them bleed or bruise easily

• Children who have tuberculosis or had other live vaccines in the past four weeks

• Children who are ill

Infographic: More About Signs And Prevention Of Rubella

Rubella is an infectious condition whose spread can be controlled using simple safety measures. If your child is exposed to the infection-causing pathogens and exhibits these signs, get them evaluated and follow these steps to prevent further disease transmission.

Illustration: Momjunction Design Team

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Dr. Pooja ParikhMBBS, DCH, DNB

Dr. Pooja Parikh is a pediatrician with 11 years of experience in the field. Her medical journey has taken her from Rajkot (PDUMC) to Vadodara (SSGH) to Mumbai (Hinduja & Breach Candy Hospital). Currently, she is actively involved in critical, intensive, and general care of 0 to 18-year-olds in the port town of Gandhidham, where she was born and brought...more

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in...more

Rohit GarooBSc, MBA

Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University. Also, he holds a certificate in Developmental Psychology from The University of Queensland and loves to expand his knowledge through certifications in various...more

Shinta Liz SunnyM.Tech

Shinta is a biotechnologist who is highly intrigued by science and technology. She holds a master's degree in Biotechnology from Karunya Institute of Technology and Sciences and a PG Diploma in cellular and molecular diagnostics from Manipal University. At MomJunction, Shinta writes on mother and child health and wellness. Previously, she worked as a scientist for three years, involved in developing...more