Rubella

Definition

Rubella is a contagious infection in which there is a rash on the skin.

Alternative Names

Three day measles; German measles

Causes, incidence, and risk factors

The disease is caused by a virus that is spread through the air or by close contact.

A person can transmit the disease from 1 week before the rash begins, until 1 - 2 weeks after the rash disappears. The disease is less contagious than rubeola (measles). After an infection, people have immunity to the disease for the rest of their lives.

In children and adults, rubella is usually mild and may even go unnoticed.

Risk factors include:

• Not being vaccinated against rubella
• Exposure to an active rubella virus

Symptoms

Children generally have few symptoms. Adults may experience a fever, headache, general discomfort (malaise), and a runny nose before the rash appears. They may not notice the symptoms.

Other symptoms may include:

• Bruising (rare)
• Inflammation of the eyes (bloodshot eyes)
• Muscle or joint pain

Signs and tests

• Nasal or throat swab for viral culture
• Rubella serology

Treatment

There is no treatment for this disease.

Patients can take acetaminophen to reduce fever.

Defects that occur with congenital rubella syndrome can be treated.

Support Groups

Expectations (prognosis)

Rubella is usually a mild infection.

However, if a mother is infected during early pregnancy, rubella can cause defects in the developing baby. The unborn baby can develop congenital rubella syndrome, which typically has a poor outcome. Defects are rare if the infection occurs after the 20th week of pregnancy.

Complications

Complications that can occur in the unborn baby:

• Cataracts
• Congenital heart defects
• Congenital rubella syndrome
• Deafness
• Ear infection (otitis media)
• Encephalitis (rare)
• Mental retardation
• Microcephaly
• Transient arthritis (common in adolescents and adults with rubella)

A miscarriage or stillbirth may occur.

Calling your health care provider

Call for an appointment with your health care provider if:

• You are a woman of childbearing age and are unsure of whether you have been vaccinated against rubella
• You or your child develop a severe headache, stiff neck, earache, or vision problems during or after a case of rubella
• You or your child need to receive MMR immunization (vaccine)

Prevention

There is a safe and effective vaccine to prevent rubella. The rubella vaccine is recommended for all children. It is routinely given when children are 12 - 15 months old, but is sometimes given earlier during epidemics. A second vaccination (booster) is routinely given to children ages 4 - 6. MMR is a combination vaccine that protects against measles, mumps, and rubella.

Women of childbearing age usually have a blood test to see if they have immunity to rubella. If they are not immune, women should avoid getting pregnant for 28 days after receiving the vaccine.

Those who should not get vaccinated include:

• Women who are pregnant
• Anyone whose immune system is affected by cancer, corticosteroid medications, or radiation treatment.

Great care is taken not to give the vaccine to a woman who is already pregnant. However, in the rare instances when pregnant women have been vaccinated, no problems have been detected in the infants.

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References

Weisberg SS. Vaccine preventable diseases: current perspectives in historical context. Dis Mon. 2007;53:467-528.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Ages 7 - 18 Years. United States. 2009.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults. United States. 2009.