Rubella (German measles)

What is rubella?

Rubella, commonly called German measles, is a relatively mild, viral illness that rarely causes noticeable symptoms in children. However, pregnant women who get infected with rubella virus also expose their babies which may result in serious complications. Infected babies can be born with defects such as cataracts, deafness, heart defects, and mental retardation, or the pregnancy can end in a miscarriage or stillbirth. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including a red rash. Rubella is caused by a different virus than measles and is neither as infectious nor as severe as measles. Rubella is now rare in the United States due to widespread immunization.

Who gets rubella?

Rubella occurs more often in persons who have never been vaccinated against rubella. Although eliminated in the United States, rubella is still common in other countries. The virus can be brought into the U.S. at any time by visitors who have rubella. Also, unvaccinated U.S. residents traveling abroad can become infected and unknowingly bring the disease back home with them.

How is rubella spread?

Rubella virus can be found in nose and throat secretions, such as saliva, sputum, or nasal mucus, of infected people. You can spread the virus to others through sneezing or coughing.

What are the symptoms of rubella?

Rubella is usually a mild illness, with a slight fever, swelling of the lymph glands (especially those in the neck), and a rash that begins on the face and lasts about three days. Children may have no symptoms, but adults may have a low grade fever, fatigue, headache, red eyes and temporary swelling and pain in the joints.

How soon after infection do symptoms appear?

The incubation period is usually 17 days but may range from 12-23 days.

How is rubella diagnosed?

Laboratory tests on blood, nasal, urine, throat, or spinal fluid samples are used to confirm the diagnosis.

When and for how long is a person able to spread the disease?

Persons with rubella are most infectious when the rash is erupting, but they can shed virus from seven days before to seven days after rash onset. Rubella may be transmitted by persons with mild or no symptoms (up to 50% of all rubella virus infections). Infants with Congenital Rubella Syndrome (CRS) shed large quantities of virus from body secretions for up to one year and can therefore transmit rubella to persons caring for them who are susceptible to the disease.

What is the treatment for rubella?

There is no specific treatment for rubella, but medications to control fever or pain may provide relief of symptoms as the body fights the virus.

How can rubella be prevented?

Immunization of as many individuals as possible is the best way to prevent rubella cases and outbreaks. One dose of rubella vaccine is recommended for all children. Rubella vaccine is included in the MMR vaccine, a combination vaccine that also protects against measles and mumps. The first dose of MMR should be given at 12-15 months of age and the second dose, specifically for protection against measles and mumps, should be administered before a child enters kindergarten (4-6 years of age). All adults born in 1957 or later without other evidence of immunity should receive one dose of MMR. Special emphasis should be placed on ensuring immunity of females of child bearing age and healthcare providers.

How can I learn more about rubella?

• If you have concerns about rubella, contact your healthcare provider.
• Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
• Visit the Centers for Disease Control and Prevention website at the CDC page on rubella.

October 2018