Rubella (German Measles)

No symptoms may occur when you are infected with rubella. This is called a 'sub-clinical infection'. If symptoms do develop, they include the following.

• Swollen glands, usually behind the ears and at the back of the neck. Sometimes glands in other parts of the body swell. The glands gradually go back to normal over a week or so.
• A spotty, pink-red rash develops anytime up to seven days after the glands swell. The rash usually starts on the face, and then spreads to the rest of the body. The rash lasts 1-5 days before fading.
• A mild fever, cold, cough, and sore throat are common
• Sore red eyes (conjunctivitis) may develop for a few days.
• Joint pains, like a mild arthritis, may develop for a week or so. This is uncommon in children, but is quite common in adults with rubella.

Bleeding disorders and brain inflammation (encephalitis) are rare complications.

Is rubella infectious?

Yes. It is passed on by direct contact and by coughing and sneezing the virus into the air. It takes 2-3 weeks to develop symptoms after being infected. You are infectious from one week before symptoms begin until five days after the rash appears. Therefore, affected children should stay away from school and not mix with others for five days after the rash starts.

If you are pregnant and have rubella in the first few months of pregnancy, there is a high chance that the virus will cause severe damage to the developing baby. The virus affects the developing organs and the baby may be born with serious disability - the 'congenital rubella syndrome'.

• If you are pregnant and come in contact with someone with rubella you should check your 'rubella status'. Your midwife or doctor will normally have a record of this if you do not know. (A blood test is routinely taken early in pregnancy. This checks to see if you are immune and have antibodies in your blood against rubella.) Most women are immune due to previous immunisation and will not develop rubella. No further action is needed if you are known to be immune.
• If you are not immune and come in contact with someone with rubella then blood tests may be advised. These can tell if you are developing rubella before symptoms begin. Further action depends on the results of these tests.
• See a doctor if you are pregnant and develop an illness that you think may be rubella. Rubella is uncommon now due to immunisation. Other viruses can cause rashes similar to rubella. Most viruses do not harm the unborn child. Blood tests can confirm or rule out rubella if it is suspected.

Tests are not usually needed unless it is important to be sure of the diagnosis. For example, blood tests may be advised if you are pregnant and do not know if you are immune.

There is no treatment that will kill the virus. Most people with rubella are not very ill, do not need any treatment, and soon make a full recovery. The immune system makes antibodies during the infection. These clear the virus and then provide lifelong immunity. It is therefore very rare to have more than one bout of rubella.

• Paracetamol (Calpol, Disprol, etc) will ease fever or aches and pains. Ibuprofen is an alternative.
• Give children lots to drink if they have a fever.
• See a doctor if any worrying or unusual symptoms develop.

Immunisation is offered to all children in the UK. It is part of the MMR (Measles, Mumps and Rubella) vaccine. Two doses are usual - the first aged 15 months and the second about three years later. Immunisation gives very good protection and so rubella is now uncommon in the UK. The number of babies born with congenital rubella syndrome has greatly reduced since routine immunisation was introduced.

If you are a women and are planning to get pregnant, if you are unsure if you are immune then see your practice nurse. A blood test will confirm if you are immune. If you are not immune then you can be immunised before you become pregnant.

© EMIS and PIP 2006   Updated: February 2006