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Rubella is a highly infectious virus that commonly affects children. It is also known as German measles. Rubella infection usually results in a mild illness. However, it can cause birth defects if the infection occurs in pregnant women, especially in the first 20 weeks of pregnancy. The virus damages the developing heart, brain, eyes and ears of the foetus. This condition is called congenital rubella syndrome.

​How It Spreads

The rubella virus is spread through the air or by close contact when the infected person coughs, sneezes or touches a surface. You or your child may contract the virus by breathing in or touching the infected droplets, and then touching your eyes, mouth or nose.

A mother with an active infection can also transmit rubella to her foetus.

Signs and Symptoms of Rubella

It’s hard to tell if someone has an active rubella infection.

In children: A child with rubella may not look or act sick. However, they might demonstrate one or some of these symptoms:
  • 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.
  • Rash, which appears in only about half the cases of rubella. When it does appear, it starts on the face and torso, and spreads to the arms and legs. The rash can last from 3 to 5 days.
In adults: Adults generally experience warning symptoms such as a fever, headache, malaise, runny nose, and inflamed eyes. This can last from 1 to 5 days before the rash appears.

Contagiousness

A child or adult can easily spread the virus 1 week before any rash appears, and without showing any symptoms. This infectious period lasts until 1 week after the rash disappears.

The good news is, once a person gets infected with the rubella virus, he has lifelong immunity to the disease.

Complications

  • ​Congenital Rubella Syndrome: Rubella becomes potentially serious when a woman is infected early in her pregnancy. This is because of the ability of the virus to produce defects in the developing foetus.
If a mother contracts rubella in the first trimester of her pregnancy, there is a 25% chance of the baby being born with congenital rubella syndrome. Some of the defects include deafness, cataracts, microcephaly, mental retardation, and congenital heart defects. However, defects are rare if the infection occurs after the 20th week of pregnancy.
  • Miscarriage or stillbirth may occur.
  • Sore, swollen joints, and arthritis in the knees, wrists and fingers (more commonly in women).
  • A brain infection called Encephalitis, a rare but serious complication caused by the rubella virus.1
1 http://www.cdc.gov/features/rubella/

Treatment and Confinement


To minimise the spread of the infection, you or your child should stay at home. Be sure to avoid any close contact with people for as long as you show any signs of the infection. If there is a rash, remember that you are still infectious up to a week after the rash disappears.

You or your child do not need any conventional medical treatment.

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

Care at Home

If your child has a fever, treat it as you normally would, such as ensuring your child gets plenty of fluids and rest. Cool sponging will help relieve the fever and discomfort from the rash. You can give your child an acetaminophen-based pain reliever. However consult your doctor before giving any fever-reducing medicine for the first time.

And remember to keep your child at home while any rash is visible, as well as for a week after the rash subsides.

Prevention

In Singapore, two doses of the MMR vaccine are recommended for children. The MMR (measles, mumps, and rubella vaccine) is now given at 12 months and 15-18 months old w.e.f 1 Dec 2011.

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.

The MMR vaccine is safe. There is no link between the MMR vaccine and autism. The article that was published in the Lancet many years ago by Dr Andrew Wakefield which resulted in the false belief that MMR is linked to Autism had been proven to be fraudulent and the article was retracted in full. Furthermore, Dr Andrew Wakefield had already been struck off from the General Medical Council Register of the United Kingdom for his involvement in the scam research. 

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