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German Measles
Introduction
German measles is sometimes called Rubella or three-day (3-day) measles. Rubella is not the same as measles (rubeola). These conditions share some characteristics, but they're caused by different viruses.
German measles and measles are both contagious viral infections best known by the distinctive red rash that may appear on the skin of those who contract either illness. However, german measles is neither as infectious nor usually as severe as measles, which is why german measles is also called three-day measles. There is one important exception: If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in the developing fetus.
The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing the illness. German measles outbreaks once were common in the United States. Today, because of widespread use of the vaccine, the Centers for Disease Control and Prevention has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated.
Signs And Symptoms
Often the signs and symptoms of german measles are so mild that they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include:
- Mild fever of 102 F or lower.
- Headache.
- Stuffy or runny nose.
- Inflamed, red eyes.
- Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears.
- A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence.
- Aching joints, especially in young women.
The cause of german measles is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child. A person with rubella is contagious from one week before the onset of the rash until about one to two weeks after the rash disappears.
German measles is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults.
The disease is still common in many parts of the world, although more than half of all countries now use a rubella vaccine. The prevalence of rubella in some other countries is something to consider before going abroad, especially if you're pregnant.
Treatment
No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others — especially pregnant women — during the infectious period.
If you contract german measles while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms but doesn't eliminate the possibility of your baby developing congenital rubella syndrome.
Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists.
Prevention
The german measles vaccine is usually given as a combined measles-mumps-rubella inoculation, which contains the safest and most effective form of each vaccine. Doctors recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school. It's particularly important that girls receive the vaccine to prevent rubella during future pregnancies.
Usually babies are protected from german measles for six to eight months after birth because of the immunity passed on from their mothers. If a child requires protection from german measles before 12 months of age — for example, for certain foreign travel — the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.
Do you need the MMR vaccine?
You don't need a vaccine if you:
- Had two doses of the MMR vaccine after 12 months of age or one dose of the MMR vaccine plus a second dose of measles vaccine.
- Have blood tests that prove you're immune to measles, mumps and rubella.
- Are a man who was born before 1957.
- Are a woman who was born before 1957 and you don't plan to have any more children, you already had the rubella vaccine or you have a positive rubella test.
- Are a nonpregnant woman of childbearing age.
- Attend college, trade school or postsecondary school.
- Work in a hospital, medical facility, child care center or school.
- Plan to travel overseas or take a cruise.
- Pregnant women or women who plan to get pregnant within the next four weeks.
- People who have had a life-threatening allergic reaction to gelatin or the antibiotic neomycin.
Side effects of the vaccine
Most people experience no side effects from the vaccine. About 15 percent of people develop a fever between seven and 12 days after the vaccination, and about 5 percent of people develop a mild rash. Some teens and adult women experience temporary joint pain or stiffness after receiving the vaccine. Fewer than one out of a million doses causes a serious allergic reaction.
In recent years, some news reports have raised concerns about a connection between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention (CDC) conclude that there is no scientifically proven link between the MMR vaccine and autism. In addition, there is no scientific benefit to separating the vaccines. These organizations note that autism is often identified in toddlers between the ages of 18 months and 30 months, which happens to be about the time children are given their first MMR vaccine. But this coincidence in timing shouldn't be mistaken for a cause-and-effect relationship.
Information obtained from National Institute of Health