Rubella

Rubella is usually a mild viral exanthem in children but has major importance because maternal infection during pregnancy can cause congenital rubella syndrome.

Transmission occurs through respiratory droplets.

Typical features include:

• Low grade fever
• Mild upper respiratory symptoms
• Fine pink maculopapular rash
• Posterior auricular and suboccipital lymphadenopathy

The rash generally begins on the face and spreads rapidly to the trunk and extremities.

Arthralgia is more common in adolescents and adults.

Complications in children are uncommon but may include encephalitis and thrombocytopenia.

Clinical diagnosis alone is unreliable because several viral exanthems appear similar.

Laboratory confirmation may include:

• Rubella IgM
• PCR in appropriate specimens

Any suspected case in a pregnant contact requires urgent public health and obstetric assessment because of fetal risk.

Treatment is supportive.

• Fluids
• Rest
• Paracetamol for discomfort

No specific antiviral treatment is available.

Prevent exposure of pregnant women.

Vaccination is the key preventive measure, but live rubella containing vaccine is contraindicated during pregnancy.