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Rubella

• Rubella [rue-BELL-uh] is a mild but very contagious viral illness. Other names for rubella are German measles and three-day measles.
• Rubella is dangerous because of its ability to harm unborn babies. Infection in a pregnant woman can result in miscarriage, stillbirth, or serious birth defects.
• People get rubella by breathing in droplets that get into the air when an infected person coughs, sneezes, or talks. Rubella can also spread by direct contact with fluids from the nose or throat of an infected person.
• Rubella can be prevented by immunization.

What is rubella?

Rubella is a mild but very contagious disease that is preventable with a vaccine. Other names for rubella are German measles and three-day measles. Rubella is dangerous because of its ability to harm unborn babies. Infection of a pregnant woman can result in miscarriage, stillbirth, or serious birth defects.

What is the infectious agent that causes rubella?

Rubella is caused by the rubella virus.

Where is rubella found?

Rubella is found worldwide.

How do people get rubella?

People get rubella by breathing in droplets that get into the air when an infected person coughs, sneezes, or talks. Rubella can also spread by direct contact with fluids from the nose or throat of an infected person.

What are the signs and symptoms of rubella?

Most cases of rubella are mild. About half of people infected with rubella virus get a rash that looks like small, fine pink spots. The rash first appears on the face and progresses from head to foot, lasting about 3 days. Children usually develop few or no other symptoms. Adults can have mild fever, headache, reddened eyes, swollen glands behind the ears, tiredness, and joint pain.

An infected person can spread the disease for as many as 5 days before the rash appears to 7 days after. Infectious children should not attend school or day care.

How soon after exposure do symptoms appear?

In most cases, symptoms appear within 16 to 18 days.

How is rubella diagnosed?

Diagnosis is by blood test or virus culture.

Who is at risk for rubella?

Anyone can get rubella, but unvaccinated, school-aged children are most at risk.

What complications can result from rubella?

Rubella is not usually a serious disease in children, but it can be very serious if a pregnant woman becomes infected. When a woman gets rubella during pregnancy, especially during the first 3 months, the infection is likely to spread to the fetus and cause congenital rubella syndrome (CRS). Up to 20% of the infants born to mothers infected with rubella during the first trimester of pregnancy have CRS. CRS can result in miscarriage, stillbirth, and severe birth defects. The most common birth defects are blindness, deafness, heart damage, and mental retardation.

What is the treatment for rubella?

There is no treatment for rubella. The illness usually runs its course in a few days.

How common are rubella and congenital rubella syndrome?

Since the rubella vaccine was introduced in 1969, cases of rubella and CRS in the United States have remained low. However, cases are reported in persons who were infected in countries that do not routinely provide rubella vaccination (imported rubella). Although CRS is preventable, up to 7 infants are born with CRS each year.

In unvaccinated populations, rubella is primarily a childhood disease. When children are well immunized, adolescent and adult infections become more evident. Since 1994, most rubella and CRS cases were associated with outbreaks among adults, and 75% of all rubella cases were among persons 15-44 years of age.

How can rubella be prevented?

Rubella can be prevented by immunization.

• All children should be vaccinated to protect themselves and others from rubella. The rubella vaccine is part of the MMR (measles, mumps, rubella) vaccine series given to children beginning at 12 months of age.
• To help protect unborn babies from CRS, women must be immune to rubella before they become pregnant. Reproductive-aged women should find out their immunization status and receive rubella vaccine if needed. Usually, a blood test will be done during pregnancy to determine if a woman is protected against rubella. Any pregnant woman who has been exposed to rubella should be referred to her health-care provider.

As is the case with all immunizations, there are important exceptions and special circumstances. Health-care providers should have the most current information on recommendations about the rubella vaccine.

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have questions about the disease described above, consult a health-care provider.

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