Rubella (German Measles)

What is rubella?

Rubella is a viral infection that usually causes a mild illness with rash. However, women who are infected with rubella any time during the first 3 months of pregnancy may have a miscarriage or stillbirth, or the child may be born with serious birth defects. These birth defects are called congenital rubella syndrome (CRS) and include heart defects, deafness, cataracts, spleen and liver damage, mental retardation, and bone disease.

Rubella used to be a common childhood disease. In the US, most children now get shots of rubella vaccine to prevent the disease, so the disease is much less common.

Rubella is often referred to as German measles or 3-day measles.

How does it occur?

The rubella virus is spread through the air by coughing or sneezing. Rubella is contagious for about a week before and 5 to 7 days after the rash begins.

Rubella occurs worldwide, and the risk of being exposed to rubella outside the US can be high. Although more than half of all countries now use rubella vaccine, the disease is still common in many countries.

What are the symptoms?

When symptoms occur, they appear about 2 to 3 weeks after exposure to the virus and they may include:

• a rash that starts on the chest or face, spreads to other parts of the body, and lasts 3 days or less (the most common symptom)
• mild fever
• runny nose and cough
• red, watery eyes
• headache
• tiredness
• joint aches
• tender, swollen lymph nodes on the back of the neck and behind and in front of the ears.

The rash first looks like a blush, and then develops into a more defined pinpoint rash. In teens and adults, other symptoms may appear 1 to 5 days before the rash. These symptoms go away quickly after the first day of rash.

You can have rubella without a rash. In fact, some adults may not have any symptoms at all.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have a blood test.

How is it treated?

Since the symptoms are so mild, treatment is not usually necessary unless you are pregnant.

If you are pregnant and have a rubella infection, medicine may be given to you if you wish to continue the pregnancy. This drug, called hyperimmune globulin, may reduce your symptoms. However, the baby is still at risk of developing CRS.

There is no specific treatment for newborns infected with rubella.

How long will the effects last?

If you have a rash, it usually goes away in a few days and you recover completely. However, a rubella infection during the first 3 months of pregnancy may cause lifelong problems for the baby. Birth defects are rare if a woman has rubella after the 20th week of pregnancy.

How can I help prevent rubella?

If you have had German measles earlier in life or have had shots against rubella, you are protected. (Rubella vaccine is included in the MMR shot.) Women of childbearing age should check with their healthcare provider to make sure they are protected before they get pregnant. Blood tests can be done to see if you are immune to rubella. If you are not immune and not pregnant, you can have the shot to protect you and your future baby. You should avoid getting pregnant until at least 28 days after the shot.

All children need to get measles shots. The first dose of rubella vaccine is given to children between 12 and 15 months of age and the second is given between the ages of 4 and 6 years.

Call your local health department or healthcare provider for more information about shots.