German Measles/Rubella – Symptoms

Rubella, also known as German Measles, commonly affects children. However, if a pregnant woman gets infected, this otherwise harmless disease can have serious consequences.

What is Rubella?
Rubella, also commonly known as German Measles, is an infection caused by the Rubella virus. Etymology tells us that the name Rubella has a Latin origin and primarily means “little red”. This is an indication of its visual symptoms. It became popularly known as German measles as it was first described by a German physicist in the mid-18th century.

By and large, Rubella is a mild infection and clears in three days. Hence, it has also become known as “three day measles”. It affects all ages, but children tend to recover faster than adults. If a pregnant woman contracts Rubella in her first trimester, it may have serious consequences for the unborn foetus resulting in what is known as the Congenital Rubella Syndrome.

Rubella is more common in children as their immune system is yet to develop. Nevertheless, adults also fall prey to this virus. Non-congenital rubella is airborne and disperses through droplets discharged through the upper respiratory tract of active Rubella cases. Urine, faeces and skin discharge may also cause contamination. Rubella has no carrier other than active human Rubella cases. The incubation period for this virus is two to three weeks. The virus generally self-limits rapidly, but lingers post-partum in infants born with Congenital Rubella Syndrome.

How to spot “spotty” Rubella
Rubella mimics the symptoms of the common flu along with the appearance of a rash. Initially the rash appears on the face and then spreads to the rest of the body. The rash is generally pink or mild red in colour. The rash is described as an exanthem as it tends to be widespread. As the rash spreads, it also starts clearing. So the face clears first and then the rest of the body follows. It usually takes three days for the rash to disappear. The rash may or may not itch depending on patient to patient. It generally leaves no scar unless there have been complications. After the rash fades flaking of the skin has been observed in some cases.

The rash is usually accompanied by low-grade fever. The temperature rarely rises above 38° C or 100.4° F. Glandular or lymph node swelling is also observed in some cases. Sub occipital and posterior cervical lymphadenopathy – or swollen lymph nodes in the neck – is a common Rubella symptom.

Other symptoms
Arthritis like joint pain (especially in women), headaches as well as conjunctivitis may be other manifestations of Rubella depending on its severity. On rare occasions, Forchheimer’s sign – eruptions of a maculopapular nature (reddish, bumpy rash) on the soft palate (back of roof of mouth) – has also been observed. Only 20% of Rubella cases show this manifestation. Often, the symptoms are so mild that Rubella goes undetected.

Symptoms of Congenital Rubella Syndrome
The symptoms of Congenital Rubella Syndrome (CRS) are quite severe. Cerebral, ocular, auditory, and cardiac defects are seen in infants with CRS. Premature delivery, low birth weight, anaemia, sight defects, auditory defects, cardiac defects (often PDA or Patent Ductus Arteriosis), hepatitis, “blueberry muffin lesions” (hemorrhagic purpuric (reddish-purplish discoloration) skin eruptions) and neonatal thrombocytopenia (not having enough platelets, or cells that help the blood to clot) are just some of the possible complications. The risk of major birth defects and organogenesis (development of baby’s organs) is heightened when the mother gets infected with Rubella in the first trimester. The chances of miscarriage and still birth also increase.