clinical features

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There is an incubation of from 14 days, up to 21 days (1), after which clinical features include:

  • prodromal symptoms - may be none in young children; older children and adults may may present with a 1-5 day prodrome with symptoms like fever, headache, malaise and upper respiratory symptoms (2)
  • pink macular rash -
    • usually the first sign of the disease, seen in 50-80% of rubella infected individuals (2,3)
    • transitory, erythematous maculopapular rash appears over one or two days. It fades within four days, leaving neither staining nor desquamation (1,2)
    • may be mildly pruritic (2)
      • develops behind the ears and on the face and neck and then spreads to the trunk and limbs (1,2)
      • in some patients no rash develops at all
  • cervical lymphadenopathy -
    • may precede the rash by a week and may persist for several weeks (2)
    • post-auricular, sub-occipital and posterior cervical nodes are commonly involved
  • arthralgia & arthritis
    • seen mostly in adolescent and adult women (60-70%)
    • usually fingers, wrists, and knees are affected symmetrically
    • symptoms tend to appear during or shortly after the rash and pain may last for about one to four weeks (2)
  • grittiness of eyes and suffusion of conjunctivae


Last reviewed 07/2021