In the past, the infection usually affected youngsters between ages six and 12 with a rash beginning on the face and spreading downward and outward to arms and legs. The rash typically runs together to make large patches, but it does not itch. It lasts for a few days, with a slight fever (less than 101°F.) and enlarged lymph nodes; some children may have a mild cough, sore throat, or runny nose before the rash appears. Sometimes the entire infection comes and goes without notice; at least 30 percent of children with rubella have no symptoms at all, although they are infectious to others.

Adolescents may have slightly more pronounced symptoms, including headaches, fever, body aches, eye infections, or a runny nose about one to five days before the rash. Swollen glands in the neck and ear typically appear seven to 10 days before the rash. The virus may be transmitted from a few days before the symptoms appear until a day after symptoms fade.

Incubation period ranges from 14 to 23 days; the average is 16 to 18 days.

Rubella may be confused with other conditions characterized by rashes, such as scarlet fever or drug allergy.

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