Rubella (German Measles)

Rubella is a contagious illness you get from a virus. It causes a rash that usually starts on your face and moves down your body. If you have rubella while pregnant, it can cause severe, lifelong health issues for your child. It spreads easily from person to person through coughing, sneezing and contaminated objects and surfaces.

Rubella has been eliminated in the U.S. for over 20 years thanks to vaccinations against the disease. This means it no longer spreads in the U.S. (but still does in other countries). It could begin spreading again if vaccination rates drop.

Rubella is also called German measles or three-day measles. But a different virus causes rubella, even though it leaves a rash like measles does.

Rubella and pregnancy

If you’re pregnant and get rubella, especially in the first trimester, your child is at high risk for congenital rubella syndrome (CRS). CRS can cause your baby to be born with conditions like cataracts, heart disease and hearing loss. It’s preventable if you’re up to date on vaccinations before getting pregnant.

Your healthcare provider may recommend a blood test for rubella before you get pregnant or while you’re pregnant. If you test positive (and you’re not currently sick), it means you’ve either had rubella before or been vaccinated against it. Either way, you’re immune to rubella and are unlikely to get it while you’re pregnant.

Symptoms of rubella

Rubella’s main symptom is a mild rash. It usually starts on your face and moves down the rest of your body. In young children, a rash is often the first symptom. In older children and adults, the rash can appear a few days after other symptoms start. Many people have no symptoms at all, but can still spread rubella to other people.

Symptoms of rubella include:

• Rash
• Low fever
• Cough
• Sore throat
• Runny nose
• Headache
• Pink eye
• Joint pain
• Generally feeling unwell (malaise)
• Swollen lymph nodes

Rubella causes

The RuV virus causes rubella. Rubella is contagious. It spreads from person to person when you cough, sneeze or touch surfaces with the virus on them. It can also spread to a fetus during pregnancy (vertical transmission). You can be contagious with rubella without symptoms.

Complications

The most common and serious complications of rubella are miscarriage and congenital rubella syndrome (CRS). CRS happens in babies born to someone who had rubella while pregnant. This can cause skin, hearing, vision, heart and brain problems in your child from birth.

Less common complications of rubella include:

• Arthritis
• Low platelets (thrombocytopenia)
• Brain swelling (encephalitis)

How doctors diagnose rubella

To diagnose rubella, your healthcare provider will examine you and look at the rash, if you have one. They might test you for rubella by getting a sample of:

• Blood
• Mucus from your nose or throat
• Pee (urine)

What does it mean if my rubella test is positive?

It depends on which type of test you took:

• If you have a positive test result from a nasal or throat swab or urine sample, it means you currently have rubella.
• If you have a positive blood test, it means you have antibodies to rubella. Assuming you’re not sick, having antibodies means you’ve had rubella before or are vaccinated for it.

You’re likely immune to rubella if you have antibodies to it — in other words, your immune system knows how to destroy it before you get sick.

How is rubella treated?

There’s no specific medicine for treating rubella. It usually gets better on its own. Your healthcare provider may suggest isolating yourself from others to reduce the spread.

Most of the time, you can manage symptoms at home with over-the-counter medicines. These include acetaminophen/paracetamol (Tylenol®, Panadol®) or cough and cold medicines. Ask your healthcare provider about the best way to treat your symptoms. Check with your pediatrician before giving medications to your child.

When should I see my healthcare provider?

If you or your child has symptoms of rubella, contact a healthcare provider. If you plan on starting a family, talk to your provider about protecting yourself against rubella before getting pregnant.

What can I expect if I have rubella?

Rubella usually causes mild illness and goes away on its own. It can be contagious for up to two weeks. You should avoid being around other people while you have symptoms and for a week after your rash appears. Talk to your healthcare provider, employer or school to know when you or your child can return.

If you get rubella while pregnant, talk to your healthcare provider about what to expect.

How long does rubella last?

The rash usually lasts about three days. Other symptoms can last a few days to a week.

Can you prevent rubella?

The best way to prevent rubella is to get the MMR (or MMRV) shot. MMR protects against measles, mumps and rubella. MMRV protects against these three diseases and chickenpox (varicella). Other ways to protect yourself against rubella include:

• Wash your hands frequently, especially if you’re sick.
• Don’t share personal items — like cups or utensils — with anyone else.
• Cover your mouth and nose when sneezing or coughing.
• If traveling, know whether rubella or other infectious diseases are more common at your destination.
• If you plan to get pregnant, talk to your provider about how to protect yourself from rubella. They usually recommend getting vaccinated at least one month before trying to get pregnant if you weren’t vaccinated in childhood.