Treatment for Rubella
Rubella treatment is entirely supportive and symptomatic, as there is no specific antiviral therapy available for this self-limited viral infection. 1, 2
Acute Infection Management
Isolation and Infection Control
- Isolate patients for 7 days after rash onset to prevent transmission, as patients remain contagious from several days before until 7 days after the rash appears 1
- This isolation period is critical for preventing spread to susceptible individuals, particularly pregnant women 2
Symptomatic Treatment
- Provide NSAIDs for joint symptoms, which occur in up to 70% of adult women with rubella and manifest as arthralgia or arthritis 1
- Manage fever and constitutional symptoms with antipyretics and rest 2
- The illness is generally mild and self-limited in children, resolving within 3 days for the rash 2, 3
Monitoring for Complications
Thrombocytopenia
- Monitor platelet counts if purpura or bleeding manifestations develop, as thrombocytopenia occurs in 1 per 3,000 cases, more commonly in children 1
Encephalitis
- Hospitalize immediately and provide supportive neurological care if encephalitis develops, which occurs in 1 per 6,000 cases and is more likely in adults 1
- Encephalitis carries a 20% mortality rate and requires intensive monitoring, though survivors typically recover within 1-3 weeks without neurologic sequelae 4
- Manage status epilepticus if it occurs as a complication of rubella encephalitis 4
Congenital Rubella Syndrome Management
Multidisciplinary Approach Required
- Infants with congenital rubella syndrome require long-term multidisciplinary management addressing cardiac defects, ophthalmologic defects, hearing loss, and developmental delays 1
- Surgical correction may be needed for patent ductus arteriosus, pulmonary artery stenosis, or septal defects, with early intervention recommended 1
Critical Prevention Focus
The cornerstone of rubella management is prevention through vaccination, not treatment of active infection. 1
Vaccination Strategy
- Administer two-dose MMR vaccine schedule for all children 1
- Ensure immunity in women of childbearing age before pregnancy through laboratory confirmation of rubella IgG antibody, which is the only reliable evidence of protection 1
- Vaccinate susceptible postpartum women to prevent congenital rubella syndrome in future pregnancies 5
Common Pitfalls to Avoid
- Do not attempt antiviral therapy—none exists for rubella 2, 3
- Do not rely on clinical diagnosis alone, as 25-50% of infections are subclinical and many rash illnesses mimic rubella 6, 3
- Do not underestimate the risk during pregnancy—infection in the first 8 weeks of gestation carries up to 85% risk of congenital defects 6
- Do not confuse IgG positivity with active infection—IgG alone indicates immunity, not disease 5