Rubella in children: how do I recognize an infection with rubella?

recognize rubella

Rubella, also known as rubella, is a worldwide and highly contagious viral infection caused by the rubella virus. The virus settles in the mucous membrane of the upper respiratory tract and multiplies in the lymphatic tissue. This causes the lymph nodes, especially in the neck and behind the ears, to swell painfully. Then, starting from the ears, a fine, light red skin rash forms, which spreads over the whole body.

Rubella usually occurs in childhood and is usually harmless and without complications. In adults, on the other hand, the likelihood of complications is much higher; Rubella can be dangerous, especially during pregnancy.

After contracting rubella, there is usually lifelong immunity. Rubella can therefore be counted among the “classic” childhood diseases. In about 2 percent of all cases, a second illness can occur. However, this is usually only the case if the initial infection or a possible vaccination was a long time ago.

Ways of transmission of rubella

Rubella is transmitted by the so-called droplet infection . Infected saliva droplets get into the air we breathe when we cough, sneeze or speak, for example, and settle in the mucous membranes of the upper respiratory tract. From there, the viruses penetrate the blood and spread throughout the body. The virus can also be transmitted through kissing or shared cutlery or crockery. However, it can only survive for a short time outside the human body, which is why an “indirect” infection via objects is rather unlikely.

The incubation period, i.e. the time between infection and the onset of the disease, is between 14 and 21 days for rubella. An infected person is contagious to others about seven days before the rash appears. The risk of infection also ends seven days after the rash has disappeared.

symptoms of rubella

Symptoms that may indicate rubella disease are:

• swollen lymph nodes behind the ears and in the neck
• noticeably flushed face
• small patchy, pale skin rash (lumps that stand out from the skin)
• possibly a slight fever
• sometimes joint pain (especially in girls aged 12 and over and women)

In half of all cases, rubella in children is almost or completely asymptomatic, so that the disease often goes unnoticed.

course of rubella

In children, rubella only rarely manifests itself as serious signs of illness. Infected people usually show atypical symptoms at first, such as headaches, coughing or a slight inflammation of the mucous membranes in the airways. Sometimes the child only complains of being slightly unwell. Soon after, the lymph nodes behind the ears and neck swell and are often palpable like a string of pearls. The typical skin rash with small, isolated, red spots usually appears about a day later. The rash starts behind the ears and then spreads over the face, neck, arms, and legs to the entire body within 24 hours. The rash usually causes little or no itching. Sometimes a slight fever develops.

After about three days, the rash resolves in the same order it came, the fever goes away, and the lymph nodes swell.

Associated diseases in rubella

While there are very few complications associated with rubella in children, the risk of serious comorbidities increases as the infected person ages. Possible complications can be:

• joint inflammation
• Inflammation of the heart muscle or pericardium
• bronchitis
• ear infection

In very rare cases, meningitis can also develop. This manifests itself as a severe headache, high fever, a stiff neck and sensitivity to touch. Not only in this case, but also if you suspect any other secondary disease, you should definitely see a doctor immediately so that you can initiate appropriate treatment.

Rubella: when to see a doctor?

If you suspect that your child has been infected with rubella, you should definitely consult a doctor so that he can make a clear diagnosis. Since the rash of rubella in the early stages can easily be confused with scarlet fever, ringworm or measles, a blood test is usually necessary to determine with certainty whether a rubella infection is present or not. Even if you are unsure whether you or your child has already contracted rubella, it is possible to determine whether or not there is immunity based on antibodies in the blood.

Because rubella is a viral infection, causal treatment with antibiotics is not effective. The rubella virus itself can therefore not be fought, only the symptoms can be alleviated. Although no special treatment is necessary in most cases, the doctor may be able to prescribe antipyretics or, if there is a possible comorbidity, anti-inflammatory medication.

What can you do about rubella?

If your child has rubella, they usually don’t need any special care because they probably don’t feel particularly sick. However, you should still take some sensible measures:

• Bed rest: Even if your child does not feel sick, his immune system is attacked by the virus. So make sure that your child takes it easy physically. Of course, if he feels fit enough, he doesn’t have to lie in bed all day. However, you should take it easy at least until the rash has subsided.
• Inform community facilities: Since rubella is contagious before the first symptoms appear, it makes sense to inform the kindergarten or school that your child is ill. In this way, people who have come into contact with your child can go straight to a doctor to determine whether they too have contracted rubella.
• Isolate the child: In order to prevent others from being infected as far as possible, it is important that your child does not go out with people again until the rash has disappeared. It’s best to wait 8 to 10 days after the rash starts before your child goes back to daycare or school or plays outside with friends.
  Note: If you are pregnant and have neither had rubella nor been vaccinated, it is especially important to be careful not to get infected. In this case, your child should be placed either in the hospital or with relatives or friends who can take care of them.

Home remedies for rubella

Rubella is mostly harmless, especially in children. However, if your child does have symptoms, you can help them with a few simple home remedies.

What to do if you have a fever

• Calf compress: If your child has a fever, it will help if you dissipate the excess heat that builds up in his body to the outside. Cool, damp compresses that you wrap around his calves are very suitable for this. To do this, dip two thin cotton or linen towels, such as tea towels, in cold water and wrap them around your child’s shins. Fix it with a dry cloth and leave it on until the wraps have dried. You can find detailed instructions in our article ” Calf wraps against fever “.
• Vinegar socks: Another method of dissipating body heat to the outside are the so-called vinegar socks. They work much like calf wraps, but are pulled over the feet instead of wrapped around the calves. To prepare, soak a pair of thin cotton stockings in a mixture of 1 quart of cold water and 5 tablespoons of vinegar essence. Wring out the socks slightly and put them on your child. If you then pull a pair of dry socks over them, you can prevent the bed or sofa from getting wet. Now let your child wear the socks until they have dried. If necessary, you can then repeat the application.

What to do about painful lymph nodes?

• Quark wraps: If the lymph nodes are severely swollen with rubella, they can sometimes hurt. Cool wraps help some children. A quark wrap is particularly suitable in this case, as it not only cools you down pleasantly, but also has an anti-inflammatory effect on the respiratory tract.
  And this is how it’s done: Spread out a gauze bandage or a thin, long cloth and spread it about a centimeter thick with room-warm quark. Fold the cloth together so that the quark is covered and then wrap the bandage around your child’s neck. Secure the wrap with a thin scarf or cloth and leave it on, preferably overnight.

prevent rubella

The only reliable prevention against rubella is vaccination against the pathogen. Since the disease usually occurs in childhood, the Standing Vaccination Committee (STIKO) of the Robert Koch Institute (RKI) recommends the first vaccination be carried out at the age of 11 to 14 months. In the second year of life, the immunization is completed with a second partial vaccination. The vaccine is usually given as a combination vaccine against measles, mumps and rubella. You can find out more about this in our article “ MMR Vaccination ”.

In Germany, about seven to ten percent of all women are not immune to rubella. However, since rubella can have serious consequences during pregnancy, it is recommended that all girls who did not have rubella in their childhood and who have not been vaccinated should catch up before puberty. If you are already pregnant and only then realize that you are not immune to rubella, a normal vaccination is no longer an option. However, your doctor can then carry out passive immunization with rubella antibodies.