FFinalistSouthampton · 2027
Child health
AKT · Child health/Infection & rashlow yield

Rubella

Rubella virus (togavirus)

Overview

A mild notifiable viral exanthem — but devastating in pregnancy (congenital rubella syndrome). Features a pink maculopapular rash and tender suboccipital/postauricular lymphadenopathy.

Recognise

  • Mild fever; pink maculopapular rash spreading face → trunk
  • Tender SUBOCCIPITAL and POSTAURICULAR lymphadenopathy
  • Forchheimer spots (palatal); arthralgia in adults

Red flags

  • Exposure in pregnancy → congenital rubella syndrome (deafness, cataracts, congenital heart disease — PDA)

Differentials & how to tell them apart

Measlesmore unwell, Koplik spots, 3 Cs, confluent rash
Scarlet feversandpaper rash, strawberry tongue, GAS
Parvovirus/enterovirusserology

Investigations

Clinical + rubella IgM/RNA. NOTIFIABLE. Test pregnant contacts urgently.

Management

Supportive; prevention via MMR vaccination

  1. 1Notify. Supportive care; exclude from school for 5 days after rash onset.
  2. 2Pregnancy exposure: urgent serology and specialist advice (congenital rubella risk).
Supportive — no specific treatment
MMR vaccine — prevention; avoided in pregnancy (live)

Key points

The key is pregnancy: first-trimester rubella causes the classic triad — sensorineural deafness, cataracts, congenital heart disease (PDA/pulmonary stenosis).

Monitor & prognosis

Pregnant contacts; complications rare.

Benign postnatally; teratogenic in pregnancy.

Source: NICE CKS; UKHSA