Rubella (German Measles)

Question 1

How is it transmitted?

Answer 1

by direct or indirect contact with droplets, primarily by nasopharyngeal secretions, but also in blood, stool, and urine. Also transmitted from mother to fetus
• Peak incidence: late winter and early spring
• Incubation period: 12–23 days (usually 14)
• Communicable: 7 days before to 7 days after onset of rash

Question 2

What are the s/s?

Answer 2

• Rash usually first sign.
• Maculopapular rash that begins on face and spreads head to foot; disappears in same order it spread, usually by the third day. On the second day the rash may appear pinpoint. Desquamation is minimal
  • In older children: lymphadenopathy (retroauricular, posterior cervical, postoccipital) 24 hours before the onset of the rash; lasting up to 1 week; low-grade fever, malaise, upper respiratory symptoms
  • Mild pruritus
  • Polyarthralgia and polyarthritis (rare in children but common in adolescents)

Question 3

Complications

Answer 3

Complications: encephalitis and thrombocytopenia (rare)
• Maternal rubella during pregnancy can result in miscarriage, fetal death, or congenital malformations.

Question 4

Nursing Interventions

Answer 4

• Comfort measures such as antipyretics, antipruritics, and analgesics for joint pain
• Droplet precautions until 7 days after onset of rash