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17 June 2016
Rubella  

Causative agent

Rubella is also known as "German Measles" and is caused by rubella virus.

Clinical features

Children usually present with a diffuse rash, but adults may experience a 1 - 5 day(s) history of low - grade fever, headache, malaise, enlargement of lymph nodes, upper respiratory symptoms and conjunctivitis followed by skin rash. The rash usually lasts for about 3 days, but some patients may not have rash at all. Arthralgia or arthritis occurs more commonly in adult women with rubella. Rubella infection can also cause anomalies in the developing foetus. Congenital rubella syndrome, characterised by deafness, eye lesions, heart malformations and mental retardation, is likely to occur in infants born to women who got infected during the first 3 months of pregnancy.

Mode of transmission

It can be transmitted by contact with secretions from nose and throat of infected persons through droplet spread or direct contact with patients. This is a highly infectious disease and the patient can pass the disease to other persons from 1 week before to 1 week after onset of rash.

Incubation period

It ranges from 12 – 23 days, usually 14 days.

Management

There is no specific treatment but drugs may be prescribed to reduce discomfort.

Prevention

  1. Maintain good personal and environmental hygiene.
     
  2. Maintain good indoor ventilation.
     
  3. Keep hands clean and wash hands properly.
     
  4. Wash hands when they are soiled by respiratory secretions e.g. after sneezing.
     
  5. Cover nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly.
     
  6. Cleanse used toys and furniture properly.
     
  7. Affected persons should be advised to stay at home for 7 days from the appearance of rash and avoid contact with any susceptible persons, particularly pregnant women. This is because pregnant women who do not have the immunity to rubella would contract the disease and their foetus could also be affected as well. Therefore, close pregnant contacts should be traced and their immunity status should be checked.
     
  8. Immunisation with rubella vaccine is effective in preventing the disease. Under the Hong Kong Childhood Immunisation Programme, children are given rubella-containing vaccine at 1 year old and in Primary 1 (Please refer to the Hong Kong Childhood Immunisation Programme).
     
  9. Women of childbearing age who are not immunised should preferably check their immunity status before pregnancy and receive rubella vaccine accordingly.
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