Ring rubella (medical erythema infectiosum) is a typical childhood disease. It can also occur in adults, but often runs differently here. In English-speaking countries, the ring rubella is called “slapped cheek disease” due to the crimson rash on the face, in this country analogous to a slap in the face. Usually she is harmless. In people with immunodeficiency and in pregnancy, an infection can have serious consequences. Read all important information about the Ringelrötel!
Quick Overview
- What are ring rubella? Infectious viral infection. Mostly affects children, less likely adults.
- Reason: Parvovirus B19
- symptoms: often no, otherwise: red rash, flu-like symptoms, itching in children, joint pain in young women
- Infection: mostly via droplet infection, more rarely via smear infection (shake hands, infected objects)
- Diagnosis: typical skin rash, blood test, possibly bone marrow sample
- Treatment: Ringelrötel often heal themselves. Possibly. you can relieve the symptoms. A vaccine or medications for the virus are not available.
- Forecast: usually good; severe course possible in pregnant women and people with weakened immune systems
Ring rubella: symptoms
An infection with the pathogen of the ring rubella (parvovirus B19) goes unnoticed in three quarters of all cases. Only a small proportion of those infected develop ringworm symptoms. These can vary: skin rash, flu-like symptoms (such as fever, headache and muscle aches) as well as anemia can occur together or isolated from each other. The course of the Ringelrötel can be quite different.
Ring rubella symptom: rash
The garland or ring-shaped rash (“KinderrotlaufIt is a characteristic symptom of ringworm, but it occurs in only about one in four patients and is thought to be not caused by ringworm, but is caused by the body’s own immune response to the pathogen.
The rash can be seen only one to two weeks after the infection with the Ringelrötel pathogen. He often shows in the face first (especially on cheeks and forehead) and then spreads to arms, legs and buttocks. With its symmetrical shape, the wavy spots above the nose can remind of a butterfly. They can change their shape during the course of the disease. In some children, the Ringelrötel rash with itching associated.
After a few days, the rash fades. However, it can flare up again and again over a period of one to two months. This can be caused by a lot of sunshine or high temperatures (eg due to a bath).
Ringworm belong, in addition to measles, rubella, chickenpox and scarlet fever, to the five childhood illnesses that can cause a rash. In English-speaking countries they are therefore also called “Fifth Disease”.
Ring rubella symptom: anemia
Anemic rubella anemia can occur because the virus particularly affects the precursors of red blood cells (the erythroblasts). These are destroyed in the episode. So the new formation of red blood cells comes out of step – anemia develops. It manifests itself in the following symptoms:
- Tiredness and exhaustion
- Skin blotches: The blood is responsible for a healthy skin color; In anemia, therefore, patients often appear pale.
- increased heart rate: In order for the body’s cells to receive enough oxygen despite anemia, the heart begins to pump blood faster through the circulation.
Dangers of the Ring Rubella Virus
In an anemia caused by Ringelrötel can in extreme cases a so-called aplastic crisis develop. The blood formation comes to a complete standstill, so that sufferers are dependent on blood transfusions. Particularly vulnerable to an aplastic crisis are people whose blood cells due to other diseases have only a short lifetime (such as thalassemia, sickle cell anemia) or their immune system can not fight the virus efficiently.
A rubella infection in girls and young women and girls can become one polyarthritis lead, so a joint inflammation in several joints. Especially affected are knee, jump and finger joints. This inflammatory reaction is a malfunction of the immune system, which, however, usually passes by itself and requires no special treatment.
Ring rubella: infection
The Ringelröteln virus spreads mostly over a droplet infection: When sneezing, coughing and blowing, infected small secretions distribute droplets in the space where the infectious virus is located. Other people can inhale the droplets and infect them. The virus-containing saliva droplets can also be applied to skin and objects. The pathogen is very stable and can survive on it for a long time. It can also be transmitted if you shake a sick person’s hand, touch a dirty doorknob or a toy (contact infection).
Ring rubella: incubation period
Ringlet rubella do not (if at all) become noticeable immediately after the infection: between the infection and the appearance of the first symptoms usually passes scarcely two weeks. This period of time is referred to as the incubation period.
Duration of infectivity
Affected but already a few days after the infection and before a rash occurs (if that ever arises), infectious. Virtually no risk of infection exists as soon as the rash develops.
The phenomenon of being contagious, even before symptoms appear, is one of the reasons why ringworm infections often affect kindergartens and schools. Affected children do not stay at home because the infection is usually not recognized. This can lead to epidemics, especially in winter and spring.
However, after a thoroughbred rubella infection, those affected are immune for a lifetime against the disease.
Ringelrötel in adults and adolescents
As a typical childhood disease, the Ringelrötel adults rarely meet. According to blood tests, 60 to 70 percent of all thirty-year-olds are already immune to the rubella – they had previously (mostly in childhood) had contact with the parvovirus B19 and have been immune to it ever since.
Anyone who first becomes infected with ring rubella as an adult rarely gets the skin rash typical of children. Most adult patients (especially young women) develop an acute one Inflammation in several joints (Polyarthritis). The symptoms are similar to the symptoms of rheumatoid arthritis. To distinguish, the physician can determine the rheumatoid factor in the patient’s blood. If this is positive, there is probably an arthritis. However, if the rheumatoid factor is negative and certain antibodies in the blood are found to be against the rubella virus, it is in fact a polyarthritis due to ringworm.
Like other childhood diseases, ringworm can cause unusually severe discomfort in adults and can be severe. It can be dangerous especially for pregnant women (see below) and people with weakened immune systems.
Especially pregnant women as well as people in close contact with pregnant women should be aware of the risk of infection with the rubella and prevent infection as much as possible (inter alia avoid contact with infected persons).
Ringelrötel in adolescents
Even in adolescents, the disease manifests itself differently than in children. Often a Ringelröteln infection leads to the so-called Glove Sock Syndrome, This is a skin rash that is strictly confined to the hands and feet – those areas of the skin that are covered by socks and gloves. The skin lesions are different from the typical ring rubella rash in that they show up in the form of small red spots or papules and increased blood vessel markings on the skin.
Ring rubella: pregnancy
Two thirds of women of childbearing age are immune to the common ringworm pathogen. That’s a good thing, because a pregnant woman gets infected with ring rubella, which can have serious consequences for the unborn child.
Although the Parovirus B19 causes no direct malformations or disabilities. However, it may enter the baby’s bloodstream through the placenta, infecting the hematopoietic cells and causing anemia. This disturbs the child’s supply of oxygen and nutrients and consequently its development.
For suspected ringworm, the pregnancy should therefore be closely monitored by ultrasound. Thus, at the first sign of a reduced blood volume in the child with appropriate measures can be countered.
Learn more about risks and treatment of ringworm in pregnancy in the article Ring Rubella – Pregnancy.
Ring rubella: causes and risk factors
Trigger of the Ringelröteln is that Parvovirus B19, It is the smallest known virus that can cause disease in humans (smallest human pathogenic virus).
Parvovirus B19 detects a specific surface structure of erythroblasts (precursors of red blood cells) and penetrates into these cells. Some people lack this characteristic structure on their blood cells. They are therefore immune to the parvovirus from birth.
The Ringelröteln pathogens are widespread. This is because infected people can pass the virus on to other people already a few days after infection and before the (possible) outbreak of the rash. The virus is very stable and can survive on surfaces outside the body for extended periods of time. This promotes dissemination. However, ringworm virus is not as infectious as, for example, measles, rubella or poxviruses. In addition, it usually causes only a harmless infection that goes unnoticed in many cases.
There is no vaccine against parvovirus B19, Therefore, you can only protect yourself from infection by avoiding close contact with infected people and washing your hands regularly.
Ring rubella: examinations and diagnosis
The doctor usually diagnoses ringworm based on the typical rash, In case of unclear symptoms or in patients without the rash may be blood test Ensure the diagnosis: In the blood of infected persons can be detected either antibodies against the Ringelröteln virus or the virus itself.
Even years after an infection with ring rubella still circulate specific antibodies against the pathogen in the blood of the person concerned. Therefore, women who want to conceive before a pregnancy can have a blood test to see whether they already had contact with the pathogen and are therefore immune to ringworm.
Only in rare cases the doctor must have one Bone marrow sample (bone marrow puncture). If the patient actually has the ring rubella, the parvovirus B19 can be detected in the sample.
Ring rubella: treatment
In most cases, the Ringelrötöteln heal by itself and need not be treated. A targeted treatment with an antiviral drug is not even available for a parvovirus B19 infection. In more severe cases, one can only try to relieve the symptoms of ringworm:
Often physicians prescribe medications for fever and pain. Cold compresses can help against the itching that sometimes accompanies the Ringworm rash. In case of severe anemia (anemia) a blood transfusion may be necessary.
Patients with a compromised immune system (immunodeficiency) sometimes receive special antibodies to help the body fight the common ringworm pathogen. However, this therapy is very expensive and only necessary for chronic anemia.
Ringelrötel: Disease course and prognosis
The course of the Ringelrötel can be very different. Many people do not notice the infection at all, while others develop flu-like symptoms, possibly followed by the typical rash. Ringworm often causes (only) joint pain, especially in young women.
The prognosis for ring rubella is generally good. In most cases, the body alone can fight the infection. Pregnant women, people with weakened immune systems and those with anemia, however, are increasingly prone to complications Fifth disease.