Rubella

There is a form of eruption which resembles measles, but differs in several particulars, and about which some dispute exists. It has received several names, as, for example; rubeola notha, roseola, rotheln, rosalia, German measles, etc. Rubella is undoubtedly the proper term for this rose-red colored eruptive fever. Very little is written of it in our text-books, although it is a disease of frequent occurrence. It is probably contagious, and is more prone to be epidemic than either measles or scarlet fever. One attack usually protects from subsequent invasion, but does not protect from either measles or scarlet fever.

Rubella occurs chiefly between the ages of three and twelve years. It may be seen in infants, rarely adults, and is characterized by stages of incubation, invasion, eruption, and decline, and closely resembles measles in some cases, and scarlet fever in others.

The history of the patient will aid diagnosis. Has the child had either scarlet fever or measles? Are either of these diseases existing epidemically? The stage of incubation varies from four to twenty-one days. The invasion stage is from twelve to twenty-four hours. Catarrhal symptoms absent, though the fauces are reddened. One of the most characteristic symptoms of rubella is the enlargement and induration of the cervical, post-cervical and post-auricular glands. Occasionally only a few of these glands may be affected, but more often the entire chain, also the lymphatic glands in other parts of the body, may be involved.


The eruption may first appear, like the eruption of measles, upon the face, but spreads more rapidly over the surface, or it may appear over the whole surface at once; it is most intense during the first day; it may rapidly fade in one part and appear in another; in color it is of a pale rose-red, but not so red as scarlet fever, nor so bluish as measles.

Over the more vascular parts it is often slightly elevated, with a tendency to become confluent. In other parts it is more maculate in form and of a much higher color in the centre; nor do we have the characteristic odor so peculiar to measles. The tongue is usually slightly coated and clean in patches, producing the so-called "mapped tongue" but never the strawberry tongue. Desquamation is slightly branny, and follows the eruption in nearly every case. In some cases it is well marked; in others, however, it may only be observed on some particular parts, as about the nose, and may last for three weeks or more. The patient very quickly recovers; there is no dropsy or renal disease following in its wake.