Pediatric Rubella Clinical Presentation

  • Author: Pamela L Dyne, MD; Chief Editor: Richard G Bachur, MD   more...
 
Updated: Apr 16, 2012
 

History

  • The incubation period of rubella is 14-23 days.
  • The prodrome is characterized by the following:
    • Malaise
    • Fever
    • Anorexia
    • Headache
    • Mild conjunctivitis
    • Rhinorrhea
  • The rash develops within 1-5 days of symptom onset, starting on the face and forehead and spreading caudally to involve the trunk and extremities.
    • The rash tends to clear in the same order as it appeared.
    • The rash may be pruritic, but it usually resolves within 3 days without residua.
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Physical

  • Lymphadenopathy may be present, particularly in the posterior auricular, posterior cervical, and suboccipital chains.
  • The rash consists of pink macules and papules, which may become confluent, resulting in a scarlatiniform eruption.
  • Petechiae of the soft palate, known as the Forchheimer sign, may be present.
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Causes

Rubella is caused by a single-stranded RNA togavirus.

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Contributor Information and Disclosures
Author

Pamela L Dyne, MD  Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Peter Bloomfield, MD, MPH  Clinical Instructor, Department of Emergency Medicine, Olive View-UCLA Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Garry Wilkes, MBBS, FACEM  Director of Emergency Medicine, Calvary Hospital, Canberra, ACT; Adjunct Associate Professor, Edith Cowan University, Western Australia

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Grace M Young, MD  Associate Professor, Department of Pediatrics, University of Maryland Medical Center

Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD  Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston

Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Kelli N McCartan, MD, to the development and writing of this article.

References

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  2. Watstein SB, Jovanovic J. Statistical Handbook on Infectious Diseases. Westport, CT: Greenwood; 2003:5.

  3. CDC. Elimination of rubella and congenital rubella syndrome--United States, 1969-2004. MMWR Morb Mortal Wkly Rep. Mar 25 2005;54(11):279-82. [Medline].

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  10. CDC. CDC. Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report. Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome—United States, 1969-2004. JAMA. 2005;293:2084-6.

  11. Fisher RG, Boyce TG. Prenatal infections. In: Moffet's Pediatric Infectious Disease: A Problem-Oriented Approach. Lippincott Williams & Wilkins; 2005:631-2.

  12. Lemstra M, Rajakumar D, Thompson A, Moraros J. The effectiveness of telephone reminders and home visits to improve measles, mumps and rubella immunization coverage rates in children. Paediatr Child Health. Jan 2011;16(1):e1-5. [Medline]. [Full Text].

  13. Maldonado Y. Rubella. In: Behrman RE, Kliegman R, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, PA: WB Saunders; 2004:1032-4.

  14. Mercurio MG, Elewski BE. Cutaneous manifestations of systemic viral, bacterial, and fungal infections and protozoal disease. In: Dermatologic Signs of Internal Disease. 2nd ed. 1995:254.

  15. Palacin PS, Castilla Y, Garzon P, Figueras C, Castellvi J, Espanol T. Congenital rubella syndrome, hyper-IgM syndrome and autoimmunity in an 18-year-old girl. J Paediatr Child Health. Oct 2007;43(10):716-8. [Medline].

  16. Sanchez PJ. Viral infections of the fetus and neonate. In: Feigin RD, Cherry J, Demmler GJ, Sheldon S, eds. Textbook of Pediatric Infectious Diseases. Philadelphia, PA: Saunders; 2004:881-5.

  17. Smith A, Yarwood J, Salisbury DM. Tracking mothers' attitudes to MMR immunisation 1996-2006. Vaccine. May 16 2007;25(20):3996-4002. [Medline].

 
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Image in a 4-year-old girl with a 4-day history of low-grade fever, symptoms of an upper respiratory tract infection, and rash. Courtesy of Pamela L. Dyne, MD.
 
 
 
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