2025 – PAGE 327 – INFECTIOUS DISEASES

(DOUBLE TAKE) RUBELLA VIRUS (AKA GERMAN MEASLES)

In children, the Rubella virus causes “German measles” and presents with a mild fever and a maculopapular rash. The rash starts on the face and then spreads to the trunk and extremities within 24 hours. The facial rash disappears as the body rash starts. The rash resolves within 3 days. In unimmunized children who get this infection, it’s generally a benign, self-limited viral illness. Diagnose with an IgM for acute cases.

• CONGENITAL RUBELLA: Most affected children were exposed during the first trimester. Eye issues are the most common finding. Exposure can result in cataracts, microphthalmia, deafness, a patent ductus arteriosus (PDA), and blueberry muffin rash.
  • PEARL: Pregnant women should NOT get the MMR vaccine (it’s live).
  • MNEMONIC: Imagine looking at a PDA (personal data assistant) with an image of a BLUE BELL. The opening of the BELL looks like an EYE, and the hammer of the bell looks like a WHITE BALL. At the top of the bell, there is a tag hanging off of it that says “LIMITED.”
    • KEY: PDA = patent ductus arteriosus, BLUE = blueberry muffin rash, BELL = ru-BELL-a, EYE SHAPED OPENING = microphthalmia and the WHITE BALL = a cataract.
• NAME ALERT/MNEMONIC: Measles, German measles, rubella, roseola, and rubeola can cause confusion. You will not be given the terms rubeola or German measles on the pediatric boards. You will be given the names as they appear in the MMR vaccine (MEASLES, mumps, and RUBELLA).