Rubella, or German measles, is usually a mild viral illness with rash and swollen lymph nodes. Infection early in pregnancy can cause miscarriage or congenital rubella syndrome, with deafness, cataracts and heart defects, which is why vaccination matters.
Key symptoms
- Low fever and mild cold symptoms
- Pink rash starting on the face and spreading down within a day
- Swollen, tender lymph nodes behind the ears and at the back of the neck
- Joint pain, especially in adult women
- Many infections have no symptoms
What you find on exam
- Fine pink rash that fades in about 3 days
- Postauricular and occipital lymph nodes
- Joint swelling in the hands or wrists
- Pregnancy status and MMR vaccine history
Tests
- Rubella IgM serology, and IgG to check immunity
- PCR from a throat or nasal swab
- In pregnancy, specialist testing to confirm infection and assess the fetus
- Report suspected cases to public health
Treatment basics
- Supportive care: rest, fluids, acetaminophen
- Droplet precautions for 7 days after rash onset
- Counseling for patients infected early in pregnancy
- MMR vaccine for non-immune people, given after delivery in pregnant patients
Red flags
- Rash or exposure in a pregnant patient
- Bleeding or easy bruising (low platelets)
- Headache, confusion or seizures
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; CDC, Guideline for Isolation Precautions (2007) and PPE sequence. Written by Making Synapses. Making Synapses is not affiliated with these organizations.