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Disease

Rubella

Page last updated on 09 November 2018

Rubella is a viral illness that causes both a skin rash and painful joints. Rubella is sometimes referred to as German measles, but it is a different disease to measles. 

Rubella is a mild illness for most people, but it can very seriously harm a pregnant woman’s unborn baby. If a pregnant woman contracts rubella in the first 10 weeks of pregnancy, their unborn baby is at great risk of developing severe and permanent birth defects (known as congenital rubella syndrome or CRS) or even death.

Rubella is uncommon in Australia due to routine vaccination programs, however outbreaks still occur. Vaccination is an important way to prevent the spread of rubella in your community. 

Key disease information

What is rubella?

Rubella is an infection caused by a virus. It is sometimes called German measles, although it is not related to measles itself.

People with rubella often get a skin rash and joint pain. In most people, rubella is a mild disease, but it can have severe consequences for an unborn baby. If a pregnant woman contracts rubella, her baby is at risk of severe and permanent birth defects or miscarriage/death.

Is the rubella virus contagious?

Rubella is highly contagious. It is spread from person to person during coughing or sneezing, or by direct contact with infectious people. 

Once infected, it can take around 14-21 days for the rash and joint pain to appear.  However, a person is infectious from 7 days before the onset of the rash and until at least 4 days after the rash appears. This means people infected with rubella could be out in the community, passing on the infection before they realise they have it.

Infants with congenital rubella syndrome (CRS) pass large quantities of the virus in their urine and faeces for up to a year and can therefore transmit rubella to those at risk, including those who are not immune to rubella or the people caring for them.

Can rubella be prevented?

Rubella is a vaccine-preventable disease. 

In Australia, immunisation against rubella is provided as part of the National Immunisation Program (NIP) as follows:

  • Children at 12 months - the first dose of rubella vaccine is given in combination with measles and mumps (as MMR vaccine)
  • Children at 18 months - the second dose of rubella vaccine is given in combination with measles, mumps and varicella (chickenpox).

If you are male and were born during or after 1966 and do not have evidence of having received two doses of a rubella vaccine, you may not have immunity against the disease and may need an additional dose of the vaccine. 

It is also recommended that any young adolescent or adult who does not have evidence of having received two doses of a rubella vaccine or other evidence of immunity should speak to their doctor about vaccination against rubella.

It is also important that women of child-bearing age are immune to rubella.

For further information regarding vaccination against rubella, speak with your healthcare professional.

How is rubella spread?

Rubella is most commonly spread when someone swallows or inhales the cough or sneeze droplets from an infected person. It can also be passed from person to person by direct contact.

What are the complications of rubella?

For most people rubella is a mild illness and they recover within about three days. 

However, possible complications of rubella include: 

  • lingering joint pain that may take a month or more to get better 
  • up to 70% of women who get rubella may experience arthritis; this is rare in children and men 
  • otitis media (inflammation of the middle ear)
  • encephalitis (inflammation of the brain), which can be fatal in some cases. 

If an unvaccinated pregnant woman becomes infected with rubella virus, she is at risk of having a miscarriage, or her baby may die shortly after birth – particularly if she is infected early in her pregnancy. The developing baby can also develop serious birth defects such as:

  • heart problems
  • loss of hearing and eyesight
  • intellectual disability
  • liver or spleen damage.
     
What is the difference between measles and rubella?
Measles Rubella
Measles is caused by a virus that specifically infects the respiratory system Rubella is caused by a virus that invades the lymph nodes, eyes and skin
More severe and can be life threatening Generally milder, but caution needed in pregnant women
Small white spots in the mouth (called Koplik spots) within 2-3 days. Then a rash, red spots spread to the body after 3-5 days Pink rash that begins in the face and moves to the body, lasts 3-5 days

 

What is congenital rubella syndrome (CRS)?

Congenital rubella syndrome (CRS) is a condition that occurs in a developing baby in the womb whose mother is infected with the rubella virus. Pregnant women who contract rubella are at risk for miscarriage or stillbirth, and their developing babies are at risk for severe birth defects with lifelong consequences. This is especially if the mother contracts the disease during the first trimester (first three months) of her pregnancy. 

About nine in every 10 unborn babies exposed to rubella during the first 10 weeks of pregnancy will have a major congenital abnormality. CRS can affect almost everything in the developing baby’s body, with the most common birth defects including:

  • deafness
  • cataracts
  • heart defects
  • intellectual disabilities
  • liver and spleen damage
  • low birth weight
  • skin rash at birth.

Less common complications from CRS can include:

  • glaucoma (an eye condition that can cause blindness)
  • brain damage
  • thyroid and other hormone problems
  • inflammation of the lungs.

It is important for women to ensure they are immune to rubella before they become pregnant.  Contact your healthcare professional for more information.

VaccineHub offers general information only. Please see a healthcare professional for medical advice

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Sources & Citations

  1. Victoria State Government. Better Health Channel. Rubella. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rubella  (accessed 15 April 2018).
  2. Queensland State Government Health. Rubella (German measles). Available at: http://conditions.health.qld.gov.au/HealthCondition/condition/14/217/122/Rubella-German-measles  (accessed 15 April 2018).
  3. Australian Government. Department of Health. The Australian Immunisation Handbook 10th Edition. 4.18 Rubella. Available at: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-18  (accessed 15 April 2018).
  4. Centres for Disease Control and Prevention. Rubella complications. Available at: https://www.cdc.gov/rubella/about/complications.html  (accessed 15 April 2018).
  5. Centres for Disease Control and Prevention. Pregnancy and Rubella. Available at: https://www.cdc.gov/rubella/pregnancy.html  (accessed 15 April 2018).
  6. Australian Government. Department of Health. The Australian Immunisation Handbook 10th Edition. 4.9 Measles. Available at: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-9 (accessed 9 May 2018).   

SPANZ.SAPAS.18.04.0138 - Date of preparation May 2018

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