If you notice swollen lymph nodes and a red, small-spotted rash all over your child's body, your little explorer may have contracted rubella. Rubella is considered a childhood disease, but adults can also become infected with the virus. The illness is usually mild, but it can have serious consequences if an unborn baby becomes infected. In this article, you’ll learn what rubella is, how it is transmitted, and how vaccination can help prevent it.

What are rubella?

Caused by rubella viruses, rubella is one of the typical childhood diseases, as it still mainly affects young children. It doesn’t matter where in the world you are: rubella viruses are worldwide widespread and infect humans exclusively. In addition, the viruses are highly contagious , which is why contact with infected people almost always leads to illness—unless there is vaccination protection or immunity from a previous rubella infection.

How are rubella transmitted?

Rubella is via droplet infection transmitted from person to person. The viruses enter the air through coughing, sneezing, or talking and can be passed on to another non-immune person. Rubella infection can also occur through direct skin contact, such as kissing. The Incubation period in rubella is very long compared to other diseases: only two to three weeks after infection do the first symptoms appear. However, infected people are contagious for a week even before symptoms become visible. Rubella can still be contagious for up to a week after the rash has disappeared and may still be transmitted during this time.

Symptoms: What do rubella look like?

Rubella can, but does not have to, be accompanied by visible symptoms. About half of all rubella cases in young children occur without clear signs. This significantly contributes to the continued spread of the viral disease today. However, if symptoms do appear, they typically begin about 14 to 21 days after infection . But how does the disease progress?

• You can often first tell that your little explorer has been infected with the rubella virus by cold-like symptoms , an increased temperature up to Fever , and possibly even conjunctivitis. In addition, there may be lymph node swelling in the neck and behind the ears.

• The typical rubella rash appears as a reddish, small-spotted skin rash on the face and usually shows up one to three days after the onset of illness. It then spreads to the legs, arms, abdomen, and back. The palate may also be covered with painless red spots. Unlike, for example, Chickenpox , rubella rarely causes itching, if at all.

Even adults who are not vaccinated can become infected with rubella. The older the person affected, the more severe the symptoms can be. The following symptoms typically occur:

• Fever

• Headaches

• Swollen lymph nodes in the neck and at the back of the head

• Stiff and swollen joints and joint pain

• Rare: Middle ear infection

How is the childhood disease diagnosed and treated? If your little explorer—or you—shows the symptoms mentioned, you should seek clarification and see a doctor . The diagnosis of rubella is almost always made based on the symptoms presented . Since the rash is often difficult to distinguish from the Measles rash , a blood test may also provide information about the viral infection. There is no medication to treat rubella. Doctors can only prescribe remedies to alleviate the symptoms .

Since rubella is a notifiable disease, your pediatrician will report the illness to the health department. It is also important that you inform the daycare and those around you. This way, other children who have been in contact with your little explorer can see their doctor right away to confirm or rule out an illness. In turn, this means your child can only return to daycare once the skin rash has been gone for a week.

Rubella during pregnancy

Rubella during pregnancy can be very dangerous for your unborn child . Especially if you, as an expectant mother, contract rubella between the first and 16th week of pregnancy , the risk of rubella embryopathy is high. The rubella viruses can cross the Placenta to the baby. Possible consequences of rubella infection for your child include damage to the inner ear, heart, and eyes, and in severe cases, the brain, liver, or spleen . A Preterm birth or Miscarriage can also be triggered by the infection. Whether your unborn baby has actually been infected with the rubella virus can be determined by an Analysis of amniotic fluid or fetal blood . Children who contract rubella in the womb are often contagious for over 12 months after birth . During this time, rubella viruses can be transmitted through their urine as well as nasal and throat secretions.

As an expectant mother, you should keep the following in mind:

• If you’re not sure whether you’ve already had a rubella infection, you can have your blood tested for antibodies. If you’re not immune, we recommend that you get vaccinated before a planned pregnancy . If you are already pregnant, vaccination is unfortunately no longer possible , because it must be administered three months before conception.

• If you are already pregnant but not immune to rubella, you should avoid contact with anyone who is ill in any case.

Rubella vaccination: protection against mumps, measles, rubella

Most young children cope with rubella infections very well. However, unborn babies should be especially protected from rubella viruses. This is only possible through the immunity of the expectant mother, which can be achieved either through illness or rubella vaccination . The Standing Committee on Vaccination (STIKO) also recommends the MMR vaccination, which combines vaccines against Mumps , Measles and rubella. This way, you can protect yourself and your little explorer from three childhood diseases at once. In total, two doses of the vaccine are administered. In children, the first vaccination takes place between the 11th and 14th month of life, and the second dose is given at the earliest four weeks later, between the 15th and 23rd month of life. As an adult, you can be vaccinated against rubella at any time, as long as you have not yet developed antibodies against the rubella virus. But how long does the rubella vaccination actually provide protection? Those who choose an MMR vaccination have lifelong immunity .

The MMR vaccination is generally well tolerated, which is why it may only trigger the body’s immune responses as side effects. These can include redness or swelling around the injection site, which typically subside after a few days.

The annual number of rubella cases in Germany is relatively low. Nevertheless, children and adults still become infected with rubella viruses—often without visible symptoms. Especially during pregnancy, you should avoid contact with infected people, and if you are planning to become pregnant, it is advisable to check your immunity beforehand. If you or your little explorer do become affected, we wish you a speedy recovery!