Rubella, or German measles, is an infection caused by the rubella virus. Symptoms are often mild, but if infection occurs during pregnancy, it can cause severe harm to the unborn child, including deafness.

Rubella is a preventable disease. Since 1969, vaccination programs have led to a dramatic fall in the number of cases, and it was declared eliminated from the United States in 2004.

However, it is important to continue vaccinating as rubella can enter the U.S. from other countries.

Between 25–50% of those who have rubella do not realize that they have it. This means that a person can come into contact with rubella and become infected without realizing it.

If infection occurs during early pregnancy, it can cause congenital rubella syndrome, a condition that can have a long-term impact on the fetus.

This article will look at the symptoms, diagnosis, and treatment of rubella and why it is important to avoid rubella.

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Symptoms of rubella normally appear 2–3 weeks after exposure.

A red rash often starts on the face and neck and moves to the trunk and limbs. After 3 days, it fades and disappears. It can be itchy.

Other symptoms include:

  • headache
  • a stuffy or runny nose
  • a mild fever
  • red, inflamed eyes
  • enlarged and tender lymph nodes
  • aching joints

Rubella is sometimes known as “three-day measles,” as symptoms can be similar. However, the symptoms of rubella are milder than those of measles. Here’s how they compare:

  • Measles causes a bright red rash, and spots may appear inside the mouth. A rubella rash is pink and mild.
  • Coughing and sneezing can spread both viruses.
  • The incubation period for measles is 11–12 days but can range from 7–21 days. For rubella, it is 2 weeks on average but can range from 12–23 days.
  • Rubella is less contagious than measles. Measles will affect up to 90% of contacts who do not have immunity.
  • Measles can lead to fatal complications. Rubella is usually only serious if it happens during pregnancy.
  • With measles, there may be a fever of 103–105º Fahrenheit (F). With rubella, there may be a mild or low-grade fever.

The measles, mumps, and rubella (MMR) vaccination can prevent infection with both viruses.

Rubella is very dangerous during pregnancy, especially if infection occurs during the first 12 weeks, which is the first trimester. At this stage, there is a 90% chance of passing the virus on to the fetus.

While infection is rare in the U.S., the risk increases with international travel.

Before a person becomes pregnant, it is important to get a vaccine against rubella. If a person received an MMR vaccine in the past, they may want to check with a doctor to make sure they have immunity before getting pregnant.

A pregnant person cannot receive the vaccine, as it uses a weakened, live virus.

If someone is exposed the virus and is pregnant, they should see a doctor immediately.

Congenital rubella syndrome occurs when a pregnant person contracts the rubella virus, and it passes through the placenta to the unborn child.

The rubella virus can move through the fetal circulatory system. It can destroy cells or prevent them from dividing.

This can trigger a pregnancy loss. It can cause severe damage to the developing fetus, especially eye problems, hearing problems, and heart damage.

Worldwide, there are an estimated 100,000 cases of congenital rubella syndrome every year.

Experts do not know exactly how the virus influences the fetus.

These effects on the infant can include:

  • hearing impairment or loss
  • cataracts
  • congenital heart disease, especially pulmonary artery stenosis and patent ductus arteriosus
  • developmental delay
  • damage to the retina, known as retinopathy
  • an unusually small head, lower jaw, or eyes

Other conditions may appear as the child develops. Research studies have found that these may include:

If a fetus contracts rubella between 12–20 weeks of pregnancy, problems are typically more mild.

If a fetus contracts rubella after the first 20 weeks of pregnancy, problems are rare.

Rubella is currently under control in the U.S., but an outbreak can be serious if it occurs.

During the years from 1962 to 1965, before there was a vaccine, there was a global rubella pandemic and some 12.5 million rubella cases in the U.S.

This resulted in:

  • 11,250 losses of pregnancy
  • 2,100 newborn deaths
  • 20,000 infants born with congenital rubella syndrome
  • 2,000 cases of encephalitis

Rubella spreads between people through coughs and sneezes.

The virus replicates in the lymph nodes and the nasopharynx, the tube connecting the nasal cavity and the soft palate.

Between 5 and 7 days after exposure, the virus spreads throughout the body in the blood, with symptoms occurring about 2 to 3 weeks after a person contracts the virus.

A person who has rubella is contagious for up to 7 days before the rash appears and up to a week after.

If a person is pregnant and they may have come into contact with rubella, they should seek medical advice at once.

A medical professional can make a diagnosis by testing a blood sample for two kinds of antibodies.

There may be a new rubella infection if IgM antibodies are present.

When a test shows that IgG antibodies are present, it indicates that a person could have a rubella infection in the present, had one in the past, or was vaccinated.

An individual does not carry the virus and never received a vaccine if neither antibody is present.

A medical professional can perform a test to detect the presence of the virus’s genetic material in a sample from a person’s body, such as from a nasal or throat swab.

No medications can shorten the rubella infection, and symptoms are usually mild enough that no treatment is necessary.

Bed rest and acetaminophen, an over-the-counter painkiller, may help relieve any symptoms.

A person with a rubella infection should avoid coming into contact with anyone who may be pregnant and anyone who has a weakened immune system until 1 week after the rash appears.

If a child has rubella, someone should inform their school.

The only way to prevent the contraction of rubella is through the MMR vaccination, which protects again measles, mumps, and rubella.

The vaccine comes in the form of a live attenuated, or weakened, virus. It is delivered at 12 to 15 months of age, with a second dose at 4 to 6 years.

Any adult who has not yet had the measles, mumps, and rubella (MMR) vaccine should get it.

The following adults are people who should not receive the MMR vaccine or should wait to receive the MMR vaccine:

  • anyone who has had a severe allergic reaction after receiving a dose of the MMR vaccine.
  • anyone who has had a severe allergic reaction to any of the ingredients in the MMR vaccine.
  • anyone who is currently pregnant or would like to be pregnant within 4 weeks of receiving the MMR vaccine.
  • anyone who has a weakened immune system due to things like cancer treatment, HIV/AIDS, or immunosuppressive drugs.
  • anyone who has a close family member (parent, sibling, or child) with a history of immune system problems.
  • anyone that’s had a condition that causes them to bruise or bleed easily
  • anyone who’s recently received a blood transfusion or other blood products.
  • anyone who currently has tuberculosis.
  • anyone who has received any other vaccinations in the past 4 weeks.

Anyone who is sick should wait until they recover before having the vaccination.

Side effects

Side effects of the vaccine are minimal. Some people may have a mild fever after the injection and may develop a minor rash.

Some teenagers or adults may experience joint aches. A severe reaction is uncommon.

There is no link between the MMR vaccination and autism. The dangers of skipping the vaccination are greater than the danger posed by any adverse effects.

Rubella, or German measles, is an infection caused by the rubella virus. The symptoms are typically mild, but can be very dangerous if the infection occurs during pregnancy.

Symptoms of rubella can include headache, fever, runny nose, aching joints, and enlarged lymph notes. Rubella is similar to measles, but the symptoms are more mild.

The best way someone can avoid a rubella infection is if they get the measles, mumps, and rubella vaccination (MMR).