What is Rubella (German Measles)

Rubella (German measles, Three Day Measles) is a contagious viral infection with mild symptoms associated with a rash.

Statistics on Rubella (German Measles)

Rubella has world-wide distribution. Although the disease occurs sporadically, epidemics also occur. It is mainly seen in children under the age of 15. After the introduction of the live MMR vaccine in 1988 there has been a marked reduction in the number of cases.

Risk Factors for Rubella (German Measles)

Rubella is caused by a virus that is spread through the air or by close contact. Rubella can also be transmitted to a fetus by a mother with an active infection, causing severe disease in the fetus. A person can transmit the disease from 1 week before the onset of the Rubella rash, until 1-2 weeks after the rash disappears. Rubella is less contagious than rubeola (measles). Lifelong immunity to Rubella follows infection. The Rubella vaccine is safe and effective in preventing rubella.

Rubella Risk factors:

  • Lack of immunisation against Rubella or immunosuppression; and
  • Exposure to an active case of rubella.

Progression of Rubella (German Measles)

  • The Rubella virus is spread via droplets and is most infective before and during the time the rash is present. Rubella incubation period is 14-21 days, averaging 18 days.
  • There may not be any visible Rubella symptoms in children under 5.
  • In older patients, they may develop malaise, fever and mild conjunctivitis, rash and lymphadenopathy may also be present.
  • Rubella Complications are rare but may include post-infectious (immune) encephalitis, thrombocytopaenic purpura (skin lesions), and arthralgia (painful joints).
  • Congenital infection include cataracts, nerve deafness, and cardiac abnormalities, as well as the generalised rubella syndrome – enlarged liver and spleen, mental retardation, low birth weight, jaundice, anaemia.

How is Rubella (German Measles) Diagnosed?

There are usually no signs of rubella infection on general investigations.

Prognosis of Rubella (German Measles)

  • Rubella is usually a mild, self-limited infection in children or adults.
  • About 25% or more infants born to mothers infected with rubella during early pregnancy will develop congenital rubella syndrome associated with a poor outcome.

How is Rubella (German Measles) Treated?

  • Rubella Treatment is supportive – there is no specific antiviral agent that can be used against rubella. Simple analgesics and anti-inflammatory agents (NSAIDs) may be used.
  • Rubella can be prevent by use of the MMR vaccine which also confers resistance against measles and mumps. Due to fear of teratogenicity (defects in the fetus due to the vaccine), use of the vaccine during pregnancy or where there is a likelihood of pregnancy within 3 months is contraindicated.
  • Pregnant mothers should avoid any contact with suspected infected cases of rubella.
  • Prophylaxis with immunoglobulin (antibodies) may be considered in pregnant women who are exposed and termination is unacceptable.

More information

Doctor giving a child an intramuscular injection in arm, shallow DOF For more information on the vaccines available to protect against Measles, Mumps and Rubella, as well as the administration, side effects and components of each vaccine, see Measles, Mumps and Rubella (MMR) Vaccine.

Rubella (German Measles) References

  1. Kumar P, Clark M. Clinical Medicine. Fourth Ed. WB Saunders, 2002.
  2. MEDLINE Plus.
  3. Timbury, MC., Notes on Medical Virology 11th Ed. Churchill Livingstone 1998.

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