Rubella fact sheet

What is rubella?

Rubella, also known as German measles, is usually a mild but highly contagious viral disease that poses a serious threat to the foetus (unborn baby), if the mother contracts the illness during pregnancy. Rubella is caused by a different virus from the one that causes regular measles.

Who gets rubella?
Rubella occurs only in humans and is primarily a childhood disease although adolescent and adults may also be affected.

What are the symptoms of rubella?
Rubella is a mild illness which may present few or no symptoms. In most cases symptoms appear within 16-18 days and may include a rash, slight fever, joint aches, headache, malaise, runny nose and reddened eyes. Joint aches, headache, loss of appetite and sore throat are more common in infected adults and teenagers than in children. The lymph nodes just behind the ears and at the back of the neck may swell, causing some soreness and/or pain. The rash, which may be itchy, first appears on the face and progresses from head to foot, lasting about three days. As many as half of all rubella cases occur without a rash.

What are the complications associated with rubella?
If a pregnant woman gets rubella during the first 3 months of pregnancy her baby is at risk of having serious birth defects or even dying. Children infected with rubella before birth may be born with one or more birth defects, which together, are referred to as congenital rubella syndrome. This is recognised by growth retardation, malformations of the heart, eyes and brain, deafness and liver, spleen and bone marrow problems.

How can a woman find out if she is susceptible to rubella?
There is a simple blood test that can determine whether a person is immune to rubella. The blood test shows whether or not a person has antibodies against the virus in the blood. People who have had the illness or were vaccinated against it produce rubella antibodies.

Can congenital rubella syndrome be prevented?
A non-immune woman can be vaccinated with the rubella vaccine alone or with a combination vaccine such as measles-mumps-rubella (MMR), so that her future children will be protected from the congenital rubella syndrome. A blood test for immunity to rubella before they become pregnant can be carried out. Women who missed being tested prior to pregnancy are routinely tested during an early prenatal visit. If a pregnant woman is not immune, she should avoid anyone who has this illness. There is no effective treatment for rubella during pregnancy, nor is there an effective way to prevent rubella in a susceptible woman who is exposed to the illness.

Pregnant women who are not immune also should consider being vaccinated after delivery, so that they will be immune during any future pregnancies. A woman who is breastfeeding her baby can safely be vaccinated.

The rubella and MMR vaccines are not recommended during pregnancy, and a woman should wait 28 days after vaccination before she attempts to conceive.

How is rubella spread?
Rubella is spread from person to person via coughing or sneezing. Rubella is also spread by direct contact with nasal or throat secretions of infected individuals. Rubella may be transmitted from seven days before to seven days after rash onset.

What can be done to prevent the spread of rubella?
Maintaining high levels of rubella immunization in the community is critical to controlling the spread. Control of the spread of rubella is needed primarily to prevent congenital rubella syndrome from occurring . Therefore, women of childbearing age should have their immunity determined and receive rubella vaccine if needed. Infected children should not attend school during their infectious period.

Does past infection with rubella make a person immune?
Yes. Immunity acquired after contracting the disease is usually permanent. Immunity to rubella does not protect a person from measles, or vice versa.

How can rubella be prevented?
There is a safe and effective vaccine to protect against rubella. The vaccine usually given is incorporated in the measles, mumps and rubella combination vaccine commonly known as MMR. There is also a vaccine that protects against rubella only. Two doses of MMR vaccine are recommended. Children usually receive the first dose between 12 and 15 months of age and the second dose between 4-7 years of age.

Is the MMR vaccine safe?
The MMR vaccine is safe and effective and generally has very few side effects. Mild reactions such as fever, redness or swelling at the injection site have been reported. Following media publicity surrounding a report published in 1998 claiming a link between MMR vaccination and autism, public confidence in some countries has been undermined. Findings of subsequent studies have shown no link between vaccination and autism. Indeed no health regulatory body in the world has changed its policy on measles vaccination as a result of this hypothesized link

Are there any plans to eliminate rubella?
In its strategy plan to eliminate measles in the European region by 2010, the World Health Organization Regional Office for Europe is also including an accelerated control of rubella and congenital rubella syndrome. This includes the achievement and maintenance of very high routine immunisation coverage and strengthening surveillance systems.

Note: The information presented by this fact sheet is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals.

Updated: 1 December 2006
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