German Measles Rubella

German measles and three-day measles are common names for rubella. The term German measles arose because the disease was first described in Germany. In contrast to varicella and rubeola, rubella is typically a mild, often unrecognized disease that is difficult to diagnose. Nevertheless, infection of pregnant women can have tragic consequences.


Characteristic symptoms of German measles are slight fever, mild cold symptoms, and enlarged lymph nodes behind the ears and on the back of the neck. After about a day, a faint rash consisting of innumerable pink spots appears over the face, chest, and abdomen (figure 22.23). Unlike rubeola, there are no diagnostic mouth lesions. Adults commonly develop painful joints, with pain generally lasting 3 weeks or less. Other symptoms generally last only a few days. The significance of rubella, however, lies not with these symptoms but rather with rubella's threat to the fetuses of pregnant women.

Causative Agent

German measles is caused by the rubella virus, a member of the togavirus family. It is a small, about 60 nm in diameter, enveloped, single-stranded, positive-sense RNA virus that can readily be cultivated in cell cultures. Surface glycoproteins give the virus in vitro hemagglutinating ability, which is inhibited by specific antibody, allowing serological identification of the virus.


The rubella virus enters the body via the respiratory route. It multiplies in the nasopharynx and enters the bloodstream, causing a

22.4 Skin Diseases Caused by Viruses 553

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