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Rubella (German measles)

Rubella is a mild viral infection which can cause complications and birth defects in unborn babies. It's also sometimes called German measles.

Rubella is now less common because of the measles, mumps and rubella (MMR) vaccination (see Prevention).

  • About rubella
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Rubella and pregnancy
  • Prevention
  • Further information
  • Sources
  • Related topics

About rubella

Rubella (German measles) is an infection caused by a togavirus. It can easily be passed on if you breathe it in. It mainly affects children because you will usually have been immunised against it, or you will have had rubella as a child. It can be particularly harmful to a pregnant woman's unborn baby if the mother doesn't have immunity to rubella.

Rubella is similar to a mild attack of measles, but it's a completely different illness and is caused by a different virus.

Symptoms

You may get rubella and have no symptoms for two to three weeks. Between two and five in every 10 people who get rubella don't notice that they have it. Symptoms are usually mild and can include:

  • a pink rash which starts then spreads from the face and lasts about three days
  • a fever
  • swelling around the ears and the back of the head which is caused by swollen glands
  • a runny nose
  • an eye infection (conjunctivitis)

Symptoms usually last for about 10 days.

Complications

Complications tend to occur more often in adults. They are rare but can include:

  • birth defects in babies if you are pregnant
  • miscarriage or stillbirth if you are pregnant
  • arthritis
  • pain in your joints caused by inflammation (arthralgia)
  • bleeding more than usual if injured (thrombocytopaenia) - this is very rare
  • inflammation of the brain (encephalitis) - this is very rare and mainly occurs in women

People who have a weak immune system are also more at risk, such as those with HIV/AIDS or illnesses such as leukaemia.

Causes

You will be able to pass on the virus for seven days before the rash develops and for four days after. Rubella is passed on when an infected person coughs or sneezes near you and you breathe in the droplets of infected mucus or saliva suspended in the air. The virus then grows in cells in the throat and lungs. You can also get rubella if you are in close or direct contact with the nose or mouth of someone with the virus.

Once infected, the virus spreads in five to seven days through the body in the blood. This is when the virus can be passed to a pregnant woman's unborn baby.

If a baby is born with rubella, he/she will have congenital rubella syndrome and can pass on the virus to other people for a year or more.

Diagnosis

Your GP will examine you and ask about your symptoms. He or she may take a swab of saliva from your mouth to test for the virus.

Rubella is a notifiable disease. This means that if your GP suspects that you have rubella, by law, he or she has to report it to their local authority, so you may be contacted as a result. This is so that there are accurate statistics of how many people in the UK are getting rubella each year.

Treatment

There is no specific treatment for rubella. Taking the painkiller you would usually take for a headache will help to ease the symptoms of rubella. Before taking any medicines ask your pharmacist for advice. Follow the instructions in the patient information leaflet that comes with the medicine.

It's also important to drink plenty of fluids to stop you becoming dehydrated; this is particularly important in young children.

For more information on treating fevers in children, please see Related topics.

Rubella and pregnancy

All pregnant women are tested for rubella. If you are in the early stages of pregnancy and get rubella, it can be passed on to your baby and cause birth defects. Birth defects can include brain conditions, eye conditions, heart problems and deafness.

The later the stage of pregnancy, the less likely rubella is to affect an unborn child. In the first 11 weeks of pregnancy, nine out of 10 women who get rubella will pass it on to their unborn baby. About two in 10 women can pass on rubella to their baby from week 11 to week 16. Between week 16 and week 20 the risk is much lower but there is still a risk that your baby may be born with deafness. If you get rubella after about week 20 of your pregnancy, there is not thought to be an increased risk of birth defects compared to a pregnancy without infection.

Prevention

The most effective way to protect against rubella is immunisation with the MMR vaccine - a combined vaccine against measles, mumps and rubella. This is usually given to children between 12 and 15 months and then between the ages of three-and-a-half and five years. The vaccine can though be given at any age.

Since its introduction in 1988, the MMR vaccine has helped reduce the number of babies born with congenital rubella syndrome. There haven't been any outbreaks of rubella in recent years but fewer children have been given the vaccine since 1997, when controversy surrounded the MMR vaccine. There is now an increased risk of getting rubella if you have not been immunised.

Pregnancy and the vaccine

Women are advised not to get pregnant for three months after having the vaccine. If you are already pregnant, the vaccine is given after the delivery of your baby. There is no treatment to prevent or reduce infection from mother to baby once you are pregnant.

For more information about the MMR vaccine, please see Related topics.

Further information

Health protection agency

Sources

  • Antenatal care: routine care for the healthy pregnant woman. National Collaborating Centre for Women's and Children's Health. October 2003:88-89. www.rcog.org.uk
  • Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. Harrison's Principles of Internal Medicine. 16th ed. USA, McGraw-Hill: 2005:1152-1154
  • Immunisation against infectious diseases 2006. "The Green Book". The Department of Health. 20 October 2007. www.dh.gov.uk
  • Measles, mumps, rubella: prevention. BMJ Clinical Evidence. clinicalevidence.bmj.com, accessed 23 October 2007
  • Rubella. Health Protection Agency. www.hpa.org.uk, accessed 23 October 2007
  • Rubella. World Health Organisation. www.who.int, accessed 23 October 2007
  • Rubella update. Talking Sense Update Spring 2003. Sense. www.sense.org.uk, accessed 18 December 2007
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005:492

Related topics

  • Fever in children
  • Measles, mumps and rubella vaccine