Rubella

Rubella, also known as the 3rd infectious disease.

Contagious viral infection that mainly affects unvaccinated adolescents, typically peaking in spring.

• Spread through respiratory droplets
• Incubation period: 2-3 weeks
• Contagiousness: 6 days before to 8 days after rash onset
• Less contagious than measles
• Virus: 50-100 nm RNA togavirus
• Infection begins in respiratory mucosa and spreads hematogenously

• Often asymptomatic
• Prodromal stage: Reduced general condition, mild to moderate fever, flu-like symptoms, joint pain, and inflammation
• Initial butterfly-shaped rash on the face, spreading to the retroauricular area
• Non-confluent, small-spotted or papular rash on the skin, remission after 3 days
• Swelling of cervical lymph glands, splenomegaly, and joint pain in some cases

• Clinical diagnosis supported by laboratory findings
• Leukopenia, eosinophilia, elevated ESR, and elevated ASL titer (1-2 weeks after onset)
• PCR for direct detection
• Hemagglutination inhibition test (HAM) for specific IgM antibodies 3-7 days after rash outbreak

• Encephalitis
• Gregg's syndrome or abortion if contracted during pregnancy

• Bland external therapy
• Isolation for up to one week after rash onset
• Bed rest
• Antipyretic measures
• Paracetamol for symptom relief
• Topical therapy with zinc-containing externals

• MMR (measles-mumps-rubella) vaccine for children from 11 months of age
• Follow-up vaccination 1 ½ to 3 months after the first dose
• Intravenous immunoglobulins for pregnant women and immunosuppressed patients exposed to rubella virus within 3 days

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3. Davidkin I, Valle M, Peltola H, et al. Etiology of Measles- and Rubella-like Illnesses in Measles, Mumps, and Rubella-Vaccinated Children. The Journal of Infectious Diseases 1998;178:1567-70.
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8. Robert Koch Institute, Epidemiological Bulletin No. 34. (2015). Rki.de. Retrieved 10 May 2016, from https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2015/Ausgaben/34_15.pdf?__blob=publicationFile