German measles, or rubella, is a mild, highly contagious childhood disease that lasts about three days as a rule, hence its popular name, three day measles. It is caused by a virus and is sometimes confused with measles, or rubeola; both conditions produce a fever, a sore throat, and a splotchy red rash, but the symptoms are more severe and long lasting in measles. Two to three weeks following exposure to the virus, the person typically develops a slight fever, headache, sore throat, swollen lymph nodes, and loss of appetite. These early symptoms may be so mild, however, that it is difficult to be sure the individual has German measles until the rash appears one to five days later. It usually starts behind the ears or on the face, rapidly spreads to the trunk and sometimes to the arms and legs, and disappears entirely within three or four days (the lymph nodes may remain swollen longer). Adults who contract German measles may have continuing joint pains for a few weeks after the rash has cleared up. Once a very common children’s disease, rubella can now be prevented through routine vaccination, which is usually given around a child’s first birthday. (Younger babies cannot be vaccinated successfully, because they still carry antibodies from their mother’s immune system and these keep the vaccine from working.) A second dose is given with the measles booster vaccine when the child is 11 or 12. Teenagers and adults who lack immunity against the disease can also contract it. The greatest danger of German measles, however, is to a developing fetus. If a pregnant woman becomes infected with the virus, it can cause congenital rubella in the child she is carrying. This can be particularly devastating if the infection occurs during the first trimester of pregnancy. possible consequences include stillbirth or serious birth defects, especially impaired hearing or deafness, eye defects or blindness, heart defects, mental retardation, and behavioral problems.
Diagnostic Studies And Procedures
A doctor can usually diagnose German measles by physical examination. If an expectant mother believes she has contracted rubella, she may have a prenatal ultrasound examination, which can detect some birth defects, such as a malformed heart, but not neurological complications. A physician may suspect congenital rubella in a newborn, if there is a possibility that the mother was exposed to the disease during pregnancy and if the baby exhibits certain birth defects. Laboratory tests of the baby’s throat secretions, urine, or blood can confirm the diagnosis.
Home care is all that is necessary, because rubella is normally mild and self limited. A doctor may recommend acetaminophen to reduce fever, but aspirin should not be given to anyone under the age of 18 who has a viral infection because of the risk of Reye’s syndrome, a serious illness characterized by severe vomiting, lethargy, personality changes, and damage to the liver and brain . The situation is much different for babies born with rubella. They usually require intensive treatment, especially if they contracted the virus during the first three months of gestation, when the various organ systems are developing. These babies often have severe heart defects that may require surgical repair early in life. In addition, many rubella children need lifelong specialized treatment, depending upon the type and extent of their birth defects. Those with hearing impairment, for example, may have to be provided with special devices and instruction to learn how to talk. A child with mental retardation will probably require special education services as well. Prevention is the best approach to congenital rubella. Studies show that 10 to 20 percent of women lack antibodies against the disease. Some experts urge that every woman be tested for rubella antibodies before becoming pregnant, even if she was once immunized or had the disease. A simple blood test can determine whether a woman has this immunity. If not, she should be vaccinated before becoming pregnant. Immunization can not be administered during pregnancy because the fetus can contract congenital rubella from the live virus vaccine. A woman who is already pregnant should also have a rubella antibody test. If she lacks immunity, she must avoid exposure to German measles, particularly during the first trimester.
A number of substances are used to treat the symptoms of German measles, they include aconite, belladonna, camphor, and sulphur. The specific medication chosen will depend upon the constellation of symptoms and their severity.
When lymph nodes are tender and swollen, pressing specific points on the hands and feet may be recommended to promote the flow of lymph. This should be done twice a day, for three minutes each time, for a duration of three weeks.
Bed rest is not necessary unless there is a high fever. Sponging or bathing the child with tepid water can lower a fever. The patient should drink plenty of fluids and eat light meals.
Other Causes of Skin Rashes
An allergic reaction to any number of substances can cause a rash that looks like that of German measles, as can a hypersensitive reaction to a medication. Prickly heat can also produce a reddish rash, but usually without any other symptoms. A rash accompanied by fever can stem from another viral infection such as chickenpox.