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Rubella

Rubella, also known as German measles, is a highly infectious but usually mild viral infection that commonly affects children. However, it can be serious when it occurs in pregnant women as it can cause serious defects in her unborn child.

Rubella is a disease caused by the rubella virus and is spread through the air or by close contact. It is not the same disease as measles, though they may appear similar.

Children may have few symptoms, but rubella symptoms in adults may include a fever, headache, malaise, runny nose and inflamed eyes that last from one to five days before a rash appears. A person can transmit the disease from one week before the onset of the rash until one week after it rash disappears. Lifelong immunity from the disease follows infection.

Rubella in Pregnancy

The disease is potentially serious because of its ability to produce defects in a developing foetus if the mother is infected during early pregnancy. As many as 10 percent to 15 percent of women in their childbearing years are susceptible to infection. Congenital rubella syndrome occurs in at least 25 percent of infants born to women who acquired rubella during the first trimester of pregnancy. Defects are rare if the infection occurs after the 20th week of pregnancy.

One or more defects may occur in an infected foetus and may include deafness, cataracts, microcephaly, mental retardation, congenital heart and other defects. A miscarriage or stillbirth may occur. It is important to vaccinate your child since immunisation is the best protection against rubella. Women who have not had rubella should be immunised against it as a precaution against getting the infection during pregnancy.

Causes and Risk Factors

Risk factors include lack of immunisation and exposure to an active case of rubella.

Signs and Symptoms of Rubella

A child with rubella may not look or act sick, but symptoms may include:

• A low-grade fever and swollen glands behind the ears and at the back and sides of the neck

• Loss of appetite, irritability, loss of interest in personal care

• A rash, which appears in only about half the cases. A rubella rash starts on the face and torso and spreads to the arms and legs, lasting three to five days

Complications

Complications of rubella such as joint pain and arthritis (more common in adult women) are rare.

If you are pregnant and are exposed to rubella, you should contact your doctor immediately. The risk of birth defects is higher the earlier the exposure occurred in your pregnancy. In some cases, your doctor may advise you to consider a therapeutic termination of your pregnancy.

Rubella Treatment at Home

Medical treatment is not necessary. Keep your child quiet, especially if he/she has a fever, though it is not necessary for the child to stay in bed. Children should be kept at home while any rash is visible and for a week afterwards.

Cool sponging will help relieve fever and discomfort from a rash. An acetaminophen-based pain reliever may also help.

Prevention

In Singapore, two doses of the MMR (measles, mumps and rubella) vaccine are recommended for children. The MMR vaccine is now given at 15 to 18 months old. If a household member is pregnant and there is any question of her not being immune, your doctor will recommend delaying immunisation of your children to prevent exposing the mother-to-be to the live, though weakened, virus in the vaccine.

At least three months before trying to become pregnant, a woman should have a blood test to see if the rubella antibodies are present; if not, she should be immunised or re-immunised.

Click here for more information on vaccine-preventable diseases, subsidies available and frequently asked questions.

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This article was last reviewed on Monday, March 25, 2024