Rubella
What is rubella?
Rubella, also known as German measles, is a contagious viral infection best known by its distinctive red rash. While it is typically mild in children and adults, rubella can be extremely dangerous during pregnancy because it can cause congenital rubella syndrome (CRS), a condition in infants caused by rubella virus infection during pregnancy, particularly in the first trimester. It causes a constellation of serious birth defects. Catching rubella during pregnancy can also cause miscarriage, stillbirth, and premature birth.
Before the rubella vaccine was introduced in 1969, widespread outbreaks occurred in the U.S. every 6 to 9 years. Between 1962 and 1965, a major rubella epidemic led to 11,000 stillbirths and 20,000 children born with CRS.
In 2004, the CDC declared that rubella had been eliminated in the U.S. However, the U.S. continues to vaccinate to prevent the virus from being reintroduced from countries where it remains prevalent.
On this page, you can explore how rubella spreads, who is at risk, what the symptoms are, and how to prevent rubella.
children were born in the U.S. with CRS caused by a rubella outbreak in the early 1960s.
How does rubella spread?
Rubella can spread to others through coughing and sneezing. It can also spread through direct contact with an infected person’s nasal or throat secretions. While rubella is no longer common in the United States, it can still be introduced by travelers returning from countries where the disease is still present.
A person with rubella is contagious for up to one week before the onset of the rash and for seven days after the rash appears. Even those who do not show symptoms can still spread the virus.
If you are pregnant and contract rubella, you can pass the virus to your developing baby, which can result in serious complications.
Anyone who is not vaccinated is at risk for contracting this disease. Rubella is especially dangerous during pregnancy and for developing babies.
What are the symptoms of rubella?
The symptoms of rubella are often so mild that they can be difficult to detect, particularly in children. When symptoms do appear, they typically surface two to three weeks after exposure to the virus and last from one to five days.
Common symptoms include:
- A fine, pink rash that begins on the face and rapidly spreads to the trunk, arms, and legs, fading in the same sequence
- Low-grade fever (less than 102°F)
- Headache
- Stuffy or runny nose
- Red, inflamed eyes
- Enlarged, tender lymph nodes
- Joint pain, especially in women (affecting up to 70% of women who contract rubella)
- Cough
Serious complications from this disease can include a range of health issues collectively known as congenital rubella syndrome (CRS). These complications may involve:
- Miscarriage, stillbirth, or premature birth
- Birth defects, such as heart malformations, hearing and vision loss, intellectual disabilities, and damage to the liver or spleen.
How do you prevent rubella?
Babies and Children
For best protection against rubella, children should receive two doses of the MMR vaccine (measles, mumps, and rubella). The recommended schedule is:
- First dose: Between 12 and 15 months of age
- Second dose: Between 4 and 6 years of age
Children may also receive the MMRV vaccine, which provides additional protection against chickenpox (varicella). Consult your child’s healthcare provider to determine which vaccine—MMR or MMRV—is most appropriate for your child.
Pregnancy
Rubella is dangerous during pregnancy, as it can lead to miscarriage or cause birth defects in the baby. If you’re planning to become pregnant, talk to your healthcare provider about getting vaccinated if you are not already immune. The MMR vaccine should not be given during pregnancy, and women should wait at least 28 days after receiving the MMR vaccine before becoming pregnant. Women who are not immune to rubella should receive the MMR vaccine after giving birth, ideally before leaving the hospital.
For more information, please visit VYF’s Pregnancy section.
Immunization Schedules
To ensure that your family is up to date on their vaccines, view or download the childhood and adult immunization schedules and talk to your healthcare provider.
