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Rubella

Rubella, also known as the German measles, is an infection in which there is a rash on the skin.

Congenital rubella is when a pregnant woman with rubella passes it to the baby that is still in her womb.

Alternative Names

Three day measles; German measles

Causes, incidence, and risk factors

Rubella is caused by a virus that is spread through the air or by close contact.

A person with rubella may spread the disease to others from 1 week before the rash begins, until 1 to 2 weeks after the rash disappears.

Because the measles-mumps-rubella (MMR) vaccine is given to most children, rubella is much less common now. Almost everyone who receives the vaccine has immunity to rubella. Immunity means that your body has built a defense to the rubella virus.

In some adults, the vaccine may wear off and not fully protect them. Women who may become pregnant and other adults may receive a booster shot.

Children and adults who were never vaccinated against rubella may still get this infection.

Symptoms

Children generally have few symptoms. Adults may experience a fever, headache, general discomfort (malaise ), and a runny nose before the rash appears. They may not notice the symptoms.

Other symptoms may include:

  • Bruising (rare)
  • Inflammation of the eyes (bloodshot eyes)
  • Muscle or joint pain

Signs and tests

A nasal or throat swab may be sent for culture.

A blood test can be done to see if a person is protected against rubella. All women who may become pregnant should have this test. If the test is negative, they will receive the vaccine.

Treatment

There is no treatment for this disease.

Patients can take acetaminophen to reduce fever.

Defects that occur with congenital rubella syndrome can be treated.

Expectations (prognosis)

Rubella is usually a mild infection.

After an infection, people have immunity to the disease for the rest of their lives.

Complications

Complications can occur in the unborn baby if the mother becomes infected during pregnancy. A miscarriage or stillbirth may occur. The child may be born with birth defects.

Calling your health care provider

Call for an appointment with your health care provider if:

  • You are a woman of childbearing age and are unsure of whether you have been vaccinated against rubella
  • You or your child develop a severe headache, stiff neck, earache, or vision problems during or after a case of rubella
  • You or your child need to receive MMR immunization (vaccine)

Prevention

There is a safe and effective vaccine to prevent rubella. The rubella vaccine is recommended for all children. It is routinely given when children are 12 to 15 months old, but is sometimes given earlier during epidemics. A second vaccination (booster) is routinely given to children ages 4 to 6. MMR is a combination vaccine that protects against measles , mumps , and rubella.

Women of childbearing age usually have a blood test to see if they have immunity to rubella. If they are not immune, women should avoid getting pregnant for 28 days after receiving the vaccine.

Those who should not get vaccinated include:

  • Women who are pregnant
  • Anyone whose immune system is affected by cancer, corticosteroid medications, or radiation treatment.

Great care is taken not to give the vaccine to a woman who is already pregnant. However, in the rare instances when pregnant women have been vaccinated, no problems have been detected in the infants.

References

Weisberg SS. Vaccine preventable diseases: current perspectives in historical context. Dis Mon. 2007;53:467-528.

Coonrod DV, Jack BW, Boggess KA. The clinical content of preconception care: immunizations as part of preconception care. Am J Obstet Gynecol. 2008;199(6 Suppl 2):S290-S295.

Centers for Disease Control and Prevention. Committee on Immunization Practices (ACIP) Recommended Immunization Schedules for Persons Aged 0 Through 18 years and Adults Aged 19 Years and Older -- United States, 2013. MMWR 2013; 62:1

Centers for Disease Control and Prevention. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years -- United States, 2013, MMWR 2013; 62: 2-8.

Updated: 2/21/2013

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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