Dawaa Reference

acute

Rubella (German Measles)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources1 source

MSF Essential Drugs 2024 - paracetamol (oral)

Verified against2 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • Rubella - disease-level clinical article (rubella-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • About a quarter to half of postnatal cases have no symptoms at all
  • After an incubation of 14 to 21 days, a mild prodrome brings low fever, tiredness, poor appetite, headache, and sore throat [fatigue · fever · headache · poor appetite · sore throat]

Signs — what you find (9)

  • Swollen glands are typically felt behind the ears, at the base of the skull, and in the front of the neck [lymphadenopathy]
  • A rash of pinpoint pink spots and bumps starts on the face and quickly spreads to the body and limbs [rash]
  • The eruption can look scarlatiniform or purpuric, lasts about 3 days, and clears in the order it appeared [purpura · rash]
  • Petechiae on the soft palate, called Forchheimer spots, are seen in roughly one in five cases [petechiae]
  • Maternal infection in the first trimester of pregnancy classically gives the newborn cataracts, a heart defect, and sensorineural hearing loss [hearing loss]
  • Affected newborns can show low birth weight, low platelets with bruising, haemolytic anaemia, and an enlarged liver and spleen [anaemia · bruising · hepatomegaly]
  • Hearing loss is the single most common finding of congenital rubella and can be the only abnormality present [hearing loss]
  • A purplish spotted blueberry-muffin rash reflects extra blood-cell production in the skin [rash]
  • Long-bone x-rays can show a radiolucent, striped celery-stalk pattern at the metaphyses

Tests (8)

  • IgM antibody to rubella by EIA is the usual test for recent postnatal infection and becomes positive about 4 days after the rash starts
  • A fourfold or greater rise in IgG between acute and convalescent samples also confirms infection
  • Low-avidity IgG helps confirm a recently acquired primary infection
  • A pregnant woman exposed to rubella should have immediate IgG testing; a negative result needs repeat IgG/IgM after 3 weeks
  • Fetal infection can be shown by IgM in fetal blood, or by rubella RNA on RT-PCR from amniotic fluid, fetal blood, or a chorionic villus sample
  • In a newborn, IgM within the first 6 months, or rising IgG after 6 to 12 months, confirms congenital infection
  • PCR on nasopharyngeal swabs, urine, or saliva detects rubella RNA and supports a CRS diagnosis
  • Postnatal ELISA for IgG in neonatal serum runs near 100 percent sensitivity and specificity under 3 months of age

If not this — what else fits (4)

  • Measles, HHV-6/7, infectious mononucleosis, and cytomegalovirus can produce a similar-looking rash
  • Zika, West Nile, Ross River fever, and Chikungunya are arboviral mimics of the rash
  • Parvovirus B19, mycoplasma, scarlet fever, and enteroviruses are other infectious look-alikes
  • Drug eruptions, contact dermatitis, and Kawasaki disease are the noninfectious mimics named

SourceStatPearls "Rubella" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Symptomatic relief of the pain and fever only. It does not treat the cause, and the dose is the same whatever the cause is.

Cautions
  • Pregnant contact with unknown or no immunity - needs urgent serology and counselling.
  • Relief only - it does not treat what is causing the pain or fever.
  • Check every other product the patient is taking for paracetamol; combination cold and flu preparations are the usual route to an accidental overdose.
  • Reduce the dose in significant liver disease, chronic alcohol use, or low body weight.
  • RED FLAG - Arthritis or encephalitis, or petechiae or bleeding from thrombocytopenia - all rare complications.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Rubella - disease-level clinical article (rubella-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Pregnant women exposed to suspected rubella require immediate serologic IgG testing; infection before 18 weeks gestation carries high risk of fetal infection/congenital malformation and may warrant discussion of pregnancy termination.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.