Ringed rubella: symptoms, infection, dangers, therapy

Fabian Dupont is a freelance writer in the NetDoktor medical department. The medical doctor is already for scientific work including Belgium, Spain, Rwanda, the USA, Great Britain, South Africa, New Zealand and Switzerland. His doctoral thesis focused on tropical neurology, but he is particularly interested in international health science (public health) and the understandable mediation of medical facts.

Carola Felchner is a freelance writer in the NetDoktor medical department and a certified training and nutrition consultant. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before her traineeship, she studied translation and interpreting in Kempten and Munich.

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical professionals.

Fifth disease (medical erythema infectiosum) are a typical childhood disease. However, it can also occur in adults, but is often different here. In English-speaking countries, the ringed rubella is called "slapped cheek disease" due to the crimson rash on the face, analogous to slap disease in this country. As a rule, it is harmless. However, infection can have serious consequences for people with immunodeficiency and during pregnancy. Read everything important about the ringing rubella here!

Quick Overview

  • What are ringed rubella? Contagious virus infection. Usually affects children, less often adults.
  • Root cause: Parvovirus B19
  • symptoms: often none, otherwise: crimson rash, flu-like symptoms, itching in children, and joint pain in young women
  • Infection: mostly via droplet infection, less often via smear infection (shake hands, infected objects)
  • Diagnosis: typical rash, blood test, bone marrow sample if necessary
  • Treatment: Ringed rubella often heals itself. Possibly. you can alleviate the symptoms. Vaccination or medication for the virus are not available.
  • Forecast: mostly good; severe course possible in pregnant women and people with weakened immune systems

Ringella: symptoms

In three-quarters of all cases, infection with the ringlet rubella pathogen (parvovirus B19) goes unnoticed. Only a small proportion of those infected develop rubella symptoms. These can be different: rash, flu-like symptoms (such as fever, headache and muscle pain) and anemia can occur together or in isolation. The course of the ringing rubella can therefore be quite different.

Marigold symptom: rash

The garland or ring-shaped rash ("Kinderrotlauf" is a characteristic symptom of ringing rubella. However, it only occurs in approximately one in four patients. Presumably, it is not triggered directly by the Ringelröteln virus, but arises from the body’s immune response to the pathogen.

The rash is only one to two weeks after being infected with the Ringed rubella pathogen can be seen. It often shows up on the face (especially on the cheeks and forehead) and then spreads to the arms, legs and buttocks. With their symmetrical shape, the wavy spots can be reminiscent of a butterfly, especially around the nose. They can change their shape in the course of the disease. For some children, the ringing rubella rash goes along itching accompanied.

The rash fades after a few days. However, it can flare up again and again over a period of one to two months. This can be caused by a lot of sunlight or high temperatures (e.g. from a bath).

In addition to measles, rubella, chickenpox and scarlet fever, ringed rubella is one of the five teething troubles that can cause a rash. In English-speaking countries they are therefore also called "fifth disease".

Ringed rubella symptom: anemia

Anemia in ringed rubella can develop because the virus particularly affects the precursors of red blood cells (the erythroblasts). These are subsequently destroyed. This is how the new formation of red blood cells comes out of step – anemia develops. It manifests itself in the following symptoms:

  • Fatigue and fatigue
  • Skin paleness: The blood is responsible for a healthy skin color; patients with anemia therefore often appear pale.
  • Increased pulse: In order for the body cells to receive enough oxygen despite anemia, the heart begins to pump the blood through the circulation faster.

Danger of the Ringelröteln virus

In extreme cases, anemia caused by ringing rubella can cause a so-called aplastic crisis develop. The blood formation comes to a complete standstill, so that those affected are dependent on blood transfusions. People who are particularly susceptible to an aplastic crisis are those whose blood cells have a short lifespan due to other diseases (such as thalassemia, sickle cell anemia) or whose immune system cannot fight the virus efficiently.

A rubella infection in girls and young women and girls can lead to one polyarthritis lead to joint inflammation in several joints. Knee, ankle and finger joints are particularly often affected. This inflammatory reaction is a faulty reaction of the immune system, which, however, usually passes by itself and does not require any special treatment.

Ringelröteln: contagion

The Ringelröteln virus usually spreads through one droplet infection: When sneezing, coughing and blowing your nose, infected people spread small droplets of secretions in the room in which the infectious virus is located. Other people can inhale the droplets and thereby infect them. The droplets of saliva containing viruses can also be deposited on 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 hands with a sick person, touch a dirty doorknob or a toy (contact infection).

Ringed rubella: incubation period

Ringed rubella is not noticeable (if at all) immediately after being infected: It is usually almost two weeks between the infection and the appearance of the first symptoms. This period is called the incubation period.

Duration of contagiousness

Affected people are infectious just a few days after the infection and before a rash occurs (if it develops at all). There is almost no risk of infection as soon as the rash develops.

The phenomenon that you are contagious before symptoms appear is partly responsible for the fact that infections with ringed rubella are particularly common in nurseries and schools. Affected children do not stay at home because the infection is usually not recognized. This can lead to real epidemics, especially in winter and spring.

After undergoing a ringlet rubella infection, however, those affected are immune for a lifetime against the disease.

Ringlet rubella in adults & youth

As a typical childhood disease, ringing rubella rarely affects adults. Blood tests show that 60 to 70 percent of all 30-year-olds are already immune to ringed rubella – they have had contact with the parvovirus B19 before (mostly in childhood) and have been immune to it since then.

Those who become infected with ringing rubella as an adult rarely get the rash that is typical of children. Most adult patients (especially young women) develop an acute one Inflammation in multiple joints (Polyarthritis). The symptoms resemble the symptoms of rheumatoid arthritis. To differentiate, the doctor can determine the rheumatoid factor in the patient’s blood. If this is positive, there is probably arthritis. If, however, the rheumatoid factor is negative and there are certain antibodies against the ringing rubella virus in the blood, it is actually polyarthritis due to ringing rubella.

Like other teething problems, ringlet rubella can cause unusually severe symptoms in adults and can be difficult. It can be particularly dangerous for pregnant women (see below) and people with weakened immune system.

Especially pregnant women and people in close contact with pregnant women should be aware of the risk of ringlet rubella infection and prevent infection as much as possible (including avoiding contact with infected people).

Ringlet rubella in adolescents

The disease also manifests itself differently in adolescents than in children. A common rubella infection leads to the so-called Glove Sock Syndrome. This is a rash that is strictly limited to the hands and feet – the areas of the skin that are covered by socks and gloves. The skin changes differ from the typical ringing rubella rash in that they appear more in the form of small, red dots or papules and an increased blood vessel pattern on the skin.


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