Rubella, also known as German measles, is a viral infection that causes a rash and other symptoms. It is airborne, meaning it can spread through tiny particles in a person’s sneezes and coughs. A pregnant person can also pass rubella to the developing fetus.

Rubella is contagious and causes a rash that typically starts on the face and then spreads to other areas of the body.

A person may also experience other symptoms, such as fever and swollen glands.

While most people may develop a mild infection, it can be dangerous for a developing fetus. During pregnancy, it can cause miscarriage or congenital abnormalities.

This article examines how rubella spreads, its risks, prevention, and more.

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Rubella spreads through the air through coughing or sneezing. A person with the virus can transmit it:

  • 1 week before a rash develops
  • 1 week after symptoms first appear

According to the Centers for Disease Control and Prevention (CDC), the United States eliminated rubella in 2004 through vaccination.

However, unvaccinated Americans can still contract the infection either while visiting countries where rubella still exists or by acquiring it from someone who has the virus and travels to the U.S.

Reportedly, less than 10 Americans contract rubella any given year.

Learn more about airborne diseases here.

According to the CDC, the rubella virus is still present in Africa, the Middle East, and South and Southeast Asia. The majority of Americans contracting rubella are due to living in or visiting other countries.

The most effective way to prevent rubella is by getting the measles, mumps, and rubella (MMR) vaccination. As the name suggests, it protects against measles, mumps, and rubella.

Doctors administer the vaccination in two doses:

  • first dose: age 12–15 months
  • second dose: age 4–6 years, or 28 days after the first dose

Adults traveling outside of the U.S. should consider getting vaccinated if they are unsure of their status, or if a lab test shows they do not have immunity to rubella.

People who are considering getting pregnant should have the vaccination before conceiving if necessary.

Learn more about vaccination myths and facts.

While rubella is no longer present in the U.S., it does not mean it is impossible to come into contact with someone who has the virus.

A person’s risk factors for transmission include:

  • being unvaccinated
  • having a weakened immune system
  • visiting or living in countries where rubella is still present

According to March of Dimes, doctors do not use a specific medication to treat a typical case of rubella. A person with rubella should get plenty of rest and drink fluids often. Taking medicines that reduce fever may also help.

If a pregnant person contracts rubella, a doctor may prescribe acetaminophen to reduce their symptoms. Doctors may recommend a blood transfusion or steroids for more serious cases.

Is acetaminophen safe to take during pregnancy? Learn more here.

A person should talk with a doctor about any international travel plans. They may recommend different vaccinations or boosters based on the destination.

A person should also review their medical history with a doctor before trying to conceive. They may recommend a person receives the MMR vaccination to prevent possible congenital abnormalities associated with the infection.

Finally, a person should consult a doctor if they develop an unexplained rash along with other symptoms. Though this may not be rubella, a doctor can help diagnose and determine the best course of treatment.

This section answers some common questions about rubella transmission.

Can rubella be transmitted during pregnancy?

A pregnant person can pass rubella on to their fetus. This is known as congenital rubella syndrome (CRS).

CRS can cause a variety of congenital abnormalities, such as deafness, intellectual disabilities, or miscarriage.

Rubella is most dangerous to a person in the first trimester of pregnancy.

Learn about viral rashes in babies and when to consult a doctor.

How long can a person with rubella be contagious?

Once a person starts to develop symptoms of rubella, they can transmit the virus for about 1 week after developing the rash.

About 25–50% of people may not develop any symptoms of rubella, but they can transmit it to others.

People traveling to countries where rubella is still present should consider vaccination.

Rubella spreads through tiny particles in coughs and sneezes. A pregnant person can also pass it to the developing fetus. When this occurs, it can cause complications such as miscarriage or congenital abnormalities.

Rubella is no longer present in the U.S. However, a person may still contract the virus when traveling to other countries.

The best way to prevent rubella is to get the MMR vaccination. This will help protect a person from acquiring the virus, even if they come into contact with people who have rubella.