Ringlet rubella


Erythema infectiosum, “5. Illness"
English: Sticker's disease


The rubella are one of the infectious diseases of viral origin that occur mainly in childhood. They fall into the category of infectious diseases that are accompanied by a flat skin rash. Rubella is a self-limiting disease - so it goes away on its own without therapy.

The reasons

The causative agent of rubella is a virus: Parvovirus B19.
This virus is spread worldwide mainly in the temperate climates.

The virus finds its way into the body through the airways. Here it multiplies in the mucous membranes.

It is transmitted from person to person by what is known as droplet infection. The disease is passed on through sneezing, coughing and the like, for example. This rarely happens through infected hands or blood products (blood transfusion). Once the rash has appeared, patients are no longer contagious.

The incubation period

The time from infection to the appearance of the first symptoms is 6-14 days. Usually the infection is asymptomatic, that is, without symptoms. Only less than a quarter of those infected actually develop a rash.

Symptoms in the early stages

In some of the rubella infections there are no specific symptoms whatsoever. However, if clinical symptoms appear, they appear after about 4-14 days of incubation, i.e. the time from infection with the virus to the onset of the disease.

In many cases, flu-like symptoms are reported with fever, headache and fatigue. Once the rash develops, the disease is no longer contagious.

If there is haemolytic anemia, i.e. anemia caused by the premature breakdown of the red blood cells, the rubella-causing virus can make the underlying disease worse because it affects the red blood cells. The formation of red blood cells can be drastically disrupted by the infection and affect the anemia. This dreaded condition is known as an aplastic crisis. People with a compromised immune system can experience further complications and difficulties in the early stages.

The symptoms of infection

As a harbinger in the early stages of the disease, there are unspecific symptoms such as fever, headache and inflammation of the respiratory system

However, the most important sign of rubella infection is the rash. It typically begins on the cheeks and spreads across the body. Because of the paler central parts, the rash on the body is also referred to as garland-like. The reddening then moves over the arms and legs and over the trunk. The rash is initially red and fades a little over time.
Joint pain is often observed after the 7th day.

Find out more about the topic here: These symptoms can be recognized by rubella.

The rash as a symptom

Rubella rash usually starts on the face. The cheeks are reddened intensely and slightly swollen. The area around the mouth and nose remains untouched. Overall, the rash on the face is in the shape of a butterfly. The skin in this area is itchy, tight, and warm.

One to two days later, the rash spreads to the torso and the extensor sides of the arms and legs. The buttocks are also affected. Later it comes to typical garland-shaped figures, as the reddening in the middle becomes more and more pale and develops further towards the edge. It is from this appearance that they owe their name to "ringel rubella". Half of people experience itching with this rash. After about 5 to 8 days, the rash resolves spontaneously. During the rash, the person is not contagious.

Also read our topics:

  • Rash with rubella
  • Red spots on the body - cause and treatment

Joint pain as a symptom

Approximately every 5th child and every 2nd adult suffer from joint pain as part of a rubella infection. The medical name for this is then parvovirus B19 arthritis, since the virus responsible is parvovirus B19.

Finger, hand, knee and ankle joints in particular are inflamed symmetrically on both sides and trigger the pain. In most cases, the pain lasts for 3-4 weeks and then heals. However, it rarely happens that the virus remains in the synovial fluid and causes symptoms beyond the specified period.

Diarrhea as a symptom

Diarrhea is one of the general symptoms associated with rubella. Typical flu symptoms such as fever, headache, body aches, nausea, vomiting and diarrhea are not uncommon.

Usually diarrhea and other symptoms occur in the initial phase of the disease, when the general condition is reduced and the rash has not yet appeared. In the case of diarrhea, you must ensure that you drink enough water and unsweetened tea and, if necessary, treat with rehydrating solutions. In the event of severe weight loss, a doctor should be consulted.

The history

The typical course of rubella rubella begins with a slightly reduced general condition in the initial phase and then changes to the phase of the characteristic rash. At the beginning there is a strong reddening of the cheeks, which is known as either butterfly erythema or slapping rash. The rash then spreads from the head to the trunk and extremities. At first the spots are confluent and gnarled and blotchy. In the course of the process, the center of the spots fades a little and the overall picture is reminiscent of a garland or a net. The rash usually lasts for 5-8 days and only occurs in every 5th patient. 50% of those affected by the rash complain of itching.

There is also the possibility of developing joint problems due to inflammation of the fingers, hands, knees or ankles. Infections of the liver, heart and brain are very rare complications in children. The majority of children, however, show few symptoms and more pronounced courses of the disease are more likely to be found in adults. However, if one of the complications mentioned occurs, healing can take up to months.

If rubella is infected, only the symptoms can be treated; there is no therapy that works directly against the virus.

The duration

The time until the onset of rubella after infection is about 4-14 days. Then a rash develops, which disappears after about five to eight days. During the rash period, the disease is no longer contagious.

Are rubella contagious?

The symptom complex known as ringlet rubella is a highly contagious disease. In this context, it should be noted that rubella is only contagious from person to person. Transmission from animal to person or from person to animal is generally not possible.

In most cases, the responsible viruses are passed on via the so-called "droplet infection". This means that a large number of pathogens can be transmitted when speaking, coughing or sneezing. It is precisely the fact that the virus can be passed on while shaking hands or after touching everyday objects that makes the rubella virus so extremely contagious.

Furthermore, the responsible parvovirus can also pass through the stool (fecal-oral infection) or various blood products lead to infection. An infection of the expectant mother with the parvovirus can also be contagious for the unborn child.

In addition, it must be noted that rubella is in most cases highly contagious even before the first symptoms appear. In terms of numbers, this means that rubella infection can be contagious up to 18 days before the onset of the disease. In this way, the pathogens can spread unhindered in schools, kindergartens or similar institutions before the first disease appears and possible prophylactic measures can be taken. This fact is also the cause of the rapid spread and the high risk of infection with rubella infection.

After the first symptoms appear, this risk of infection increases again many times over, as large amounts of the pathogen are released from the person's organism. But especially in the days before the typical rash occurs, rubella is particularly contagious. During this period, the risk of infection for the immediate environment of the person concerned is greatest. As soon as the rubella-specific rash develops, the risk of infection decreases quickly.

In many cases, rubella is no longer contagious at all when the first rash appears. Furthermore, it must be noted that not everyone develops symptoms after the pathogen has been transmitted. Even so, these people are highly contagious for a few days.

The risk of becoming infected with the virus responsible is also not the same for everyone. Children between the ages of 5 and 15 are particularly at risk. There is also a high risk of infection for young people and old people when they come into contact with an infected person. In addition, people who suffer from a weak immune system (immune deficiency) are particularly at risk.

How long is ring rubella contagious?

The infection with rubella is so common that 70% of adults in Germany have gone through an infection. The incubation period begins at the time of infection and lasts around 4-14 days and ends as soon as the disease breaks out.

At the time of the appearance of the rash, also known as "erythema infectiosum", the disease is clearly recognizable and can be diagnosed. However, then you are no longer contagious. Rubella is only contagious until the reddening of the skin begins.

The diagnosis

The diagnosis is made, among other things, by means of the rash. But especially the blood count provides clues. Antibodies and viral DNA can be detected using special techniques (PCR).

More general information on the topic Blood test you'll find here.

What do you see in the blood count?

No blood draw is necessary if the symptoms are mild. If there are also chronic blood diseases, it makes sense to check the blood values, as the virus settles in the precursor cells of the red blood cells. In some cases this can lead to mild anemia, that is, anemia. Clinically, this can be indicated by paleness and fatigue.
In anemia, the hemoglobin value (measured value of the blood pigment) and the red blood cells are low. The precursors of the red blood cells, i.e. the reticulocytes, can also be reduced in rubella anemia.

Find out more about the topic here: Anemia.

The therapy

As for all viral infections, no suitable drug is available to date. However, treatment is not necessary either. Medicines for itching can be prescribed if necessary.

Homeopathy as a therapeutic alternative

The cause of the rubella disease cannot be treated with conventional medicine or homeopathic medicine. However, some remedies can be used to alleviate symptoms.

In the event of a fever and deteriorated general condition, bed rest should be maintained and sufficient amounts of water should be consumed. For the itching, you can wash with bran or whey, for example. You can also soak sachets of oatmeal in water and then repeatedly squeeze it out onto the itchy skin and let it dry. This can be practically done in the bathtub without much effort.

The complications

Complications are rare. In the case of immune incompetents, for example, the course can become chronic.
If a pregnant woman becomes infected with rubella, this infection leads to damage to the fetus in 10-15% of cases.

Read more about this: Rubella in the fraternity

The prophylaxis

To date there is no vaccination against rubella. Contact with sick people should be avoided if possible.
As the disease usually proceeds without complications, prophylaxis is only necessary for certain people.

Is there a vaccination against rubella?

There is no vaccination against rubella.
As a rule, the infection with rubella is very mild; complications can only occur in patients with a weakened or suppressed immune system or in people with sickle cell anemia.

Read more on the subject at: Vaccinations in the baby

Can you get the rubella twice?

If there is an infection with the parvovirus-B19, i.e. the causative agent of rubella, the immune system of the human body forms antibodies that fight against the virus. These antibodies remain in the body even after the illness and recognize the virus immediately if it tries to invade the body again.
This recognition mechanism prevents you from contracting rubella a second time; you are immune for a lifetime.

The only listed complication that can occur more often is joint inflammation associated with parvovirus B-19.

Rubella in adults

The infection is usually more severe in adults than in children. This leads to a feeling of illness, which can be associated with a slightly increased temperature. This is followed by a rash, which can spread over the face to the whole body. Since the main age of the disease is between 5 and 15 years, the first infection is possible in adulthood, but less likely than in childhood.

For many people, the disease has passed unnoticed in childhood. Once infected, there is lifelong immunity, so you cannot get infected with it a second time.

Read more about the topic here: Rubella in adults.

Rubella during pregnancy

Pregnant women are particularly at risk of being infected with rubella. In about 30% of cases, it can be transmitted to the unborn child. This leads to anemia in the child and, as a result, to fluid retention (Hydrops fetalis). This can be potentially life-threatening for the fetus and the pregnancy can be terminated.

When can you go back to exercise after rubella?

Since the severity of the clinical symptoms of rubella varies greatly among patients, it is not possible to make a general statement as to when exactly one should exercise again. Basically, you should take it easy for 1-2 weeks after the fever and give your body time to regenerate.

In the case of anemia, it is advisable to get used to physical activity slowly and not to overexert yourself. In the case of severe anemia, blood tests should be carried out and the doctor should individually discuss when it is advisable to resume sporting activities.

The special features of the baby

Basically, an infection with rubella is harmless and not very harmful when it comes to the general condition of the patient. Babies or toddlers, too, often show only slight health problems and a milder course than adults.

However, the complications for an unborn baby are feared if the pregnant mother becomes infected with the rubella virus. In almost every third pregnancy, the mother transmits the virus to the child and can thus cause damage to the blood cells with subsequent anemia.
Between the 13th and 20th week of pregnancy, the risk of developing fetal hydrops, i.e. an accumulation of fluid in the cavities of the child's body, is particularly high. Further complications can be an inflammation of the heart or a resulting heart failure. In the worst case, the unborn child can die from being infected with the virus.

For regular check-ups, the pregnant woman has to have an ultrasound check at short intervals. There is no causal therapy; however, in cases of severe anemia, blood transfusion via the umbilical cord can be carried out.

Find out more about the topic here: Rubella during pregnancy.

When can a child go back to kindergarten?

Ringlet rubella is only contagious until the characteristic rash breaks out. If a child feels sick and has a high temperature, it is not allowed to go to kindergarten anyway. This is usually the case during the phase of the illness, when a rash has not yet appeared. If the rash then occurs, other people can no longer become infected and staying away from kindergarten has no advantages.

Since rubella is dangerous for unborn children, only women who are protected against rubella are allowed to work in kindergartens.

Read more about the topic here: Rash with rubella.


Ringlet rubella is an infectious disease caused by viruses. The transfer takes place through Droplet infection.
It usually occurs in toddler or school age and occurs preferentially in the winter and spring months. The initial stage is characterized by general symptoms. Now follows a rash that spreads from the face to the rest skin spreads. The rash is itchy and has a typical ring shape. Therapy is not necessary. Infection can only occur between the onset of the initial phase and the appearance of the rash. Complications are only to be expected in rare cases, whereby immunosuppressed and pregnant women must exercise particular caution.
There is still no vaccination, so exposure prophylaxis, i.e. staying away from infected people, is the only effective measure.