Rubella

What Is Rubella (German Measles)?

Rubella, sometimes called “German measles,” is a disease caused by a virus. The infection is usually mild with fever and rash, but if a pregnant woman gets infected, the virus can cause serious birth defects. The measles-mumps-rubella (MMR) vaccine is the best way to help protect against rubella. Women should make sure they are protected from rubella before getting pregnant.

Burden

During the last major rubella epidemic in the US from 1964-1965:

• 12.5 million people got rubella
• 11,000 pregnant women lost their babies
• 2,100 newborns died
• 20,000 babies were born with congenital rubella syndrome (CRS)

Since the rubella vaccine became available in the US, the number of people infected with rubella dropped dramatically. Currently, less than 10 people in the US contract rubella each year.

Although rubella was declared eliminated from the US in 2004, cases can occur when unvaccinated individuals are exposed to infected individuals, mostly through international travel.

Anyone who is not vaccinated against rubella is at risk of getting the disease. It is important that children and women of childbearing age are vaccinated against rubella.

Symptoms

Children

In children, rubella usually causes a low-grade fever (less than 101 degrees) and a rash that starts on the face and spreads to the rest of the body. These symptoms may last two or three days. Older children with rubella usually first suffer from low-grade fever, swollen glands in the neck or behind the ears, and upper respiratory infection, before they develop a rash. Rubella is usually mild in children.

Adults

Complications of rubella are rare, but they occur more often in adults. Adults (especially young women) may have aching joints, headache, and pink eye before the rash appears. Up to 70% of women who get rubella may experience arthritis; this is rare in children and men. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems.

About 25-50% of people who get rubella do not have symptoms.

Pregnant Women

Rubella is very dangerous for pregnant women and their developing babies. If a pregnant woman is infected with rubella, she can pass the virus to her baby, which can lead to a miscarriage or an infant born with the congenital rubella syndrome (CRS). CRS can cause severe birth defects such as heart problems, loss of hearing and eyesight, intellectual disability, and liver or spleen damage.

Prevention

Rubella spreads when an infected person coughs or sneezes and touches objects or surfaces with unwashed hands. The disease is most contagious when the infected person has a rash. But it can spread up to seven days before the rash appears and up to seven days after. People without symptoms can still spread rubella.

The measles-mumps-rubella (MMR) vaccine can help prevent rubella. Two doses of the vaccine are
recommended for children. The first dose of MMR vaccine is usually given at age 12-15 months; the second dose is given at age 4-6 years.

Because MMR vaccine is an attenuated (weakened) live virus vaccine, pregnant women should not get MMR vaccine. Women who are planning to become pregnant should check with their healthcare professional to make sure they are vaccinated before they get pregnant.

Treatment

There are currently no medications available to treat rubella. Mild symptoms can be managed with bed rest and medicines for fever.

Updated June 2020
Source: Centers for Disease Control and Prevention