Rubella (German Measles) - Topic Overview

Topic Overview

What is rubella?

Rubella, also called German measles or 3-day measles, is a disease caused by the rubella virus. Rubella is generally a mild illness that does not result in long-term problems.

What causes rubella?

The rubella virus is most often spread through droplets of fluid from the mucous membranes that contain the virus. An infected person can spread these droplets by coughing, sneezing, talking, or sharing food and drinks. You can become infected by touching a surface contaminated with the droplets and then touching your eyes, nose, or mouth before washing your hands. Less commonly, you can get the virus through contact with infected blood if it gets on broken skin or on your hands and you don't wash them immediately.

What are the symptoms?

Symptoms of rubella include a mild fever, swollen glands (especially behind the ear and at the back of the head), and a skin rash that starts on the face and spreads to the neck, the chest, and the rest of the body. Older children and teenagers may have fever, eye pain, sore throat, and body aches. They may or may not develop a rash. See an illustration of a rash caused by rubella.

If you are infected with rubella, you are most contagious a few days before the rash develops until 5 to 7 days after it first appears. The incubation period—the time from exposure to the virus until you develop symptoms—is 14 to 21 days. However, as many as 25% to 50% of those infected with the rubella virus do not develop any symptoms.¹ All people infected with rubella are contagious, regardless of whether they have symptoms.

Generally, rubella causes only mild illness and no long-term problems. However, if you are pregnant and get infected with the rubella virus, you can give the disease to your fetus. Serious birth defects called congenital rubella syndrome (CRS) may occur in the first trimester. CRS birth defects include cataracts and other eye problems, hearing impairment, and heart disease. The rubella vaccination was developed mainly to prevent these birth defects.

How is rubella diagnosed?

A rubella blood test identifies antibodies to the rubella virus in a sample of blood. This information can help a doctor determine whether a recent infection was caused by the rubella virus. It is also used to determine whether you have been vaccinated against rubella or are otherwise immune to the virus.

Sometimes, a viral culture may also be used to determine whether a current infection is caused by the rubella virus. However, the results from this test may not be available for several weeks.

How is it treated?

Treatment for rubella involves caring for the specific symptoms. Acetaminophen, such as Tylenol, can be given to children and adults for fever. Do not give aspirin to anyone younger than 20 because of the possible link between aspirin and Reye's syndrome.

If you are pregnant and susceptible (not immune) to rubella, talk to your health professional. He or she may recommend an injection of immune globulin (IG) if you are exposed to the virus. Immune globulin does not prevent rubella infection, but it may reduce the severity of the symptoms and lower the risk for birth defects. However, immune globulin does not eliminate the risk of a child being born with a birth defect due to congenital rubella syndrome (CRS). Children with CRS have been born to mothers who have received immune globulin.

Can rubella be prevented?

In the United States, the rubella vaccine is part of the normal childhood measles (rubeola), mumps, and rubella immunization (MMR). The rubella vaccine protects 90% of immunized people from getting this disease.¹ Before a standard nationwide vaccine program began in 1969, rubella outbreaks occurred every 6 to 9 years. From 1969 to 1999, the number of rubella cases in the U.S. decreased by 99%.² However, about 10% of young adults in the U.S. have not had the rubella vaccine.¹ Susceptible young adults who become infected with rubella often are exposed to the virus in a college or work setting.

Rubella outbreaks in the United States since the mid-1990s have mostly affected people who were born in Mexico and Central America. In these countries, rubella vaccinations are not given routinely or their immunization programs are very new.^{2, 3, 4} In the United States, most infants who are born with congenital rubella syndrome (CRS) have foreign-born mothers.²

Babies born with rubella (passed from an infected mother during pregnancy) may be contagious through their first birthday. These infants can spread the illness to others who are susceptible and have not developed an immunity through immunization or prior history of the disease.¹

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

Frequently Asked Questions