Rubella (German Measles)

Topic Overview

What is rubella?

Rubella is a disease caused by the rubella virus. It is usually a mild illness that does not cause long-term problems.

But if you are pregnant and get infected with the rubella virus, you can give the disease to your baby (fetus). In the first trimester, this can cause serious birth defects called congenital rubella syndrome (CRS). CRS birth defects include hearing loss, cataracts and other eye problems, heart problems, and other health problems.

Rubella also is called German measles or 3-day measles.

What causes rubella?

The rubella virus most often is spread through droplets of fluid from the mouth, nose, or eyes of someone who has the infection. A person who has the infection can spread these droplets by coughing, sneezing, talking, or sharing food or drinks. You can become infected by touching something that has the droplets on it and then touching your eyes, nose, or mouth before washing your hands.

What are the symptoms?

Symptoms of rubella may include:

• A mild fever.
• Swollen glands, especially behind the ear and at the back of the head.
• A skin rash that starts on the face and spreads to the neck, the chest, and the rest of the body.

Women also may have joint pain. Older children and teens also may have eye pain, a sore throat, and body aches. Young children may have only a rash.

Symptoms may not start until 14 to 21 days after you've been near someone who has the infection. Some people don't have symptoms. But everyone who is infected can spread the disease.

If you have rubella, you are most likely to spread it a few days before the rash starts until 5 to 7 days after the rash first appears. See a picture of a rash caused by rubella .

How is rubella diagnosed?

A blood test can help your doctor find out if a recent infection you've had was caused by the rubella virus. The test also shows if you have been immunized against rubella or are immune to the virus.

You also may need a viral culture. This test can tell for sure that you have rubella. But the results may not be available for several weeks.

How is it treated?

Treatment for rubella focuses on treating the symptoms. Acetaminophen, such as Tylenol, can be given to children and adults to help with fever and body aches. Do not give aspirin to anyone younger than age 20. It has been linked to Reye syndrome, a serious illness.

If you are pregnant and are not immune to rubella, talk to your doctor. He or she may give you a shot of immune globulin (IG) if you have been exposed to the virus. IG does not prevent rubella infection, but it may make symptoms less severe and lower the chance of birth defects. But it may not protect your child from birth defects. Children with congenital rubella syndrome (CRS) have been born to mothers who have received IG.

Can rubella be prevented?

In the United States, the rubella shot is part of the normal childhood measles, mumps, and rubella immunization (MMR). The rubella shot protects at least 9 out of 10 immunized people from getting this disease.¹ Outbreaks may occur in people who haven't gotten the shot. Outbreaks are more likely to happen in college, military, health care, and child care settings and among people who have recently moved to the United States from other countries.¹

If you are planning to become pregnant and you don't know if you're immune to rubella, get a blood test to find out. If you're not immune, you can safely get the rubella shot up to 1 month before you become pregnant.

It is very unlikely that a person who has had rubella will get the disease again.

Frequently Asked Questions

Learning about rubella:	What is rubella? What causes it?
Being diagnosed:	What are the symptoms of rubella? How is it diagnosed?
Getting treatment:	How is rubella treated? What can I do to treat symptoms of rubella at home?
Ongoing concerns:	Can rubella be prevented?

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Author:	Debby Golonka, MPH	Last Updated: September 11, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
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