Rubella in baby and child

Rubella is one of the viral infectious diseases and usually occurs in childhood. Typical for this disease is a red skin rash, which often begins on the face and spreads further over the body. A clustered occurrence is found especially in the spring months. Especially at the beginning of the infection, it is difficult to distinguish between the clinical picture of rubella and that of measles or scarlet fever. The infection rate is lower with rubella than with other viral infections such as measles or chickenpox.

80-90% of infections occur in childhood or adolescence, which can be measured by positive antibodies against the rubella virus in the blood of young adults. In fact, these antibodies develop after infection with the virus and provide lifelong protection against re-infection. In about half of cases, the infection is very mild or even asymptomatic and thus often goes undiagnosed. Since the vaccination rate of children against the rubella virus is now very high, rubella only occurs rarely.

Rubella, or German measles, is caused by the rubella virus. The infection is transmitted via the airway by droplets. Thus, when infected persons speak or sneeze, virus particles are released into the environment, from where they in turn infect the respiratory tract of other people. The virus then enters the body via the mucous membrane and can spread via the bloodstream. The incubation period, i.e. the period from infection to the appearance of symptoms, is usually between 14 and 21 days.

Symptoms usually appear 14 to 21 days after infection with the virus. The duration of contagiousness is 1 week before rash onset to 1 week after. About 50% of rubella infections go unnoticed due to lack of symptoms. The other half of cases have a very typical course:

The initial stage of rubella is characterized by nonspecific symptoms similar to a cold. Headache, increased temperature, rhinitis, but also conjunctivitis of the eyes occur frequently. Painful swelling of the lymph nodes in the neck and behind the ears is also typical. Either these general symptoms remain, whereby the diagnosis of rubella is often not made, or the rash appears after a few days. This usually begins behind the ears, where it is rarely discovered. Subsequently, the red spots also appear on the face and spread from there to the entire body and extremities. Mild fever is not uncommon in children, but itching is rather atypical of rubella. The children usually make a lively and not very sick impression, the rash usually recedes within 3 days.

Most often, the doctor is able to diagnose rubella clinically, that is, on the basis of the medical history and symptoms, such as about the nature of the rash and swollen lymph nodes. It can sometimes be difficult to distinguish rubella from other viral infections. In such cases, antibodies directed against the rubella virus can be measured in the blood and the diagnosis made in this way.

There is no direct therapy against rubella, but it is usually sufficient to treat the disease symptomatically. Thus, one can administer suitable for children, fever-reducing drugs or painkillers.

If the child seems to be tired, then bed rest and protection is important. It should be remembered that rubella is contagious and that there are also adults who do not have protective antibodies. Those who have had the disease once are protected by lifelong immunity and will not contract rubella a second time.

Although rubella is harmless in most cases, complications such as inflammation of the joints can sometimes occur. In isolated cases, inflammation of the brain, also called encephalitis, can also develop. This can be indicated by severe headaches, nausea and vomiting. Changes in the child's behaviour or sensitivity to touch can also be considered conspicuous.

However, caution is advised during pregnancy. If the few mothers who do not have protection against rubella are infected by the virus before the 17th week of pregnancy, there is a risk of rubella embryopathy. This dreaded damage to the unborn child results in sensorineural hearing loss, heart defects and cataracts.

The child should stay at home for about ten days to avoid infecting other people.

The best way to protect yourself from infection with the rubella virus is to get vaccinated. The vaccination is usually carried out in children between the 12th and 15th month as part of the measles-mumps-rubella vaccination. In order to achieve sufficient protection, a second vaccination must be carried out in the 2nd year of life. However, this should in no case take place earlier than one month after the first vaccination.

An important goal of the vaccination is to avoid first infections during pregnancy, as this can lead to severe damage to the child. However, since vaccinating girls alone has not led to the desired success in the past, it is also important that boys are vaccinated.

If the vaccination status is unclear or if one is not sure whether one has already contracted rubella, an antibody test in the blood can bring clarity. This is especially important for girls and women who want to become pregnant.