Rubella (german measles) is a viral infection that's now rare in the UK. It's usually a mild condition that gets better without treatment in 7 to 10 days.
Symptoms of rubella include:
- a red-pink skin rash made up of small spots
- swollen glands around the head and neck
- a high temperature (fever)
- cold-like symptoms such as a cough and runny nose
- aching and painful joints – more common in adults
The symptoms of rubella usually only last a few days, but your glands may be swollen for several weeks.
Read more about the symptoms of rubella.
When to see your GP
You should always contact your GP or the 111 service if you suspect rubella.
Don't visit your GP surgery without phoning first, as arrangements may need to be made to reduce the risk of infecting others.
If you're pregnant and develop a rash or come into contact with someone who has a rash, contact your GP or midwife immediately.
Read more about diagnosing rubella.
Rubella and pregnancy
Rubella usually only becomes a serious concern if a pregnant woman catches the infection during the first 20 weeks of her pregnancy.
This is because the rubella virus can disrupt the development of the baby and cause a wide range of health problems, including:
The birth defects caused by the rubella virus are known as congenital rubella syndrome (CRS).
Since the introduction of the mumps, measles and rubella (MMR) vaccine, CRS is now very rare in the UK.
Read more about the complications of rubella.
How it spreads
Rubella is caused by a type of virus called a togavirus. It's spread in a similar way to a cold or flu, through droplets of moisture from the nose or throat of someone who's infected. These droplets are released into the air when someone coughs, sneezes or talks.
You can become infected if you come into contact with the droplets from an infected person, although it can take two to three weeks for symptoms to develop.
If you have rubella, you'll be infectious to other people from one week before symptoms develop, and for up to four days after the rash first appeared.
You should stay away from school or work for four days after the rash starts to avoid infecting others, and try to avoid contact with pregnant women during this time.
Who's affected?
Rubella is rare in the UK nowadays. Most cases occur in people who came to the UK from countries that don't offer routine immunisation against rubella.
However, there can occasionally be large outbreaks of rubella in the UK. One of these occurred in 1996, when there were almost 4,000 cases in England and Wales. There were 12 confirmed cases of rubella in England and Wales in 2013.
Treating rubella
There's no specific treatment for rubella, but symptoms normally pass within 7 to 10 days. If you or your child are finding the symptoms uncomfortable, you can treat some of these at home while you wait for the infection to pass.
For example, paracetamol or ibuprofen can be used to reduce the fever and treat any aches or pains. Liquid infant paracetamol can be used for young children. Aspirin shouldn't be given to children under the age of 16 years.
Read more about treating rubella.
Preventing rubella
The best way to prevent rubella is to be immunised with the MMR vaccine. Children are offered this vaccine as part of the routine childhood immunisation programme.
It's given in 2 doses – the first when your child is between 12 and 13 months old, followed by a second booster dose before they start school, at three years and four months.
Routine immunisation is important because it reduces the risk of large outbreaks and helps protect pregnant women and their babies.
The MMR vaccine can also be given to older children and adults who haven't been fully immunised before.
Contact your GP if you're uncertain whether you or your child are up-to-date with immunisations.
If you're thinking of getting pregnant and you're not sure whether you've had two doses of the MMR vaccine, it's a good idea to check with your GP practice. If your records show you haven't had two doses of MMR or there's no record, ask for the vaccine.
Read more about preventing rubella.
Information about you
If you or your child has rubella, your clinical team will pass information about you/your child on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).
This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.
Find out more about the register.
Burden
During the last major rubella epidemic in the US from 1964-1965:
- 12.5 million people got rubella
- 11,000 pregnant women lost their babies
- 2,100 newborns died
- 20,000 babies were born with congenital rubella syndrome (CRS)
Since the rubella vaccine became available in the US, the number of people infected with rubella dropped dramatically. Currently, less than 10 people in the US contract rubella each year.
Although rubella was declared eliminated from the US in 2004, cases can occur when unvaccinated individuals are exposed to infected individuals, mostly through international travel.
Anyone who is not vaccinated against rubella is at risk of getting the disease. It is important that children and women of childbearing age are vaccinated against rubella.
Symptoms
Children
In children, rubella usually causes a low-grade fever (less than 101 degrees) and a rash that starts on the face and spreads to the rest of the body. These symptoms may last two or three days. Older children with rubella usually first suffer from low-grade fever, swollen glands in the neck or behind the ears, and upper respiratory infection, before they develop a rash. Rubella is usually mild in children.
Adults
Complications of rubella are rare, but they occur more often in adults. Adults (especially young women) may have aching joints, headache, and pink eye before the rash appears. Up to 70 percent of women who get rubella may experience arthritis; this is rare in children and men. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems.
About 25-50 percent of people who get rubella do not have symptoms.
Pregnant Women
Rubella is very dangerous for pregnant women and their developing babies. If a pregnant woman is infected with rubella, she can pass the virus to her baby, which can lead to a miscarriage or an infant born with the congenital rubella syndrome (CRS). CRS can cause severe birth defects such as heart problems, loss of hearing and eyesight, intellectual disability, and liver or spleen damage.
Prevention
Rubella spreads when an infected person coughs or sneezes and touches objects or surfaces with unwashed hands. The disease is most contagious when the infected person has a rash. But it can spread up to seven days before the rash appears and up to seven days after. People without symptoms can still spread rubella.
The measles-mumps-rubella (MMR) vaccine can help prevent rubella. Two doses of the vaccine are recommended. The first dose of MMR vaccine is usually given at age 12-15 months; the second dose is given at age 4-6 years.
Because MMR vaccine is an attenuated (weakened) live virus vaccine, pregnant women should not get MMR vaccine. Women who are planning to become pregnant should check with their healthcare professional to make sure they are vaccinated before they get pregnant.
Treatment
There are currently no medications available to treat rubella. Mild symptoms can be managed with bed rest and medicines for fever.
Updated June 2020
Source: Centers for Disease Control and Prevention
Rubella is an infection that causes mild flu-like symptoms and a rash.
Vaccines usually given in childhood prevent you from getting the infection.
Up to half of people infected with rubella don’t have any symptoms but still can spread it to others.
You can get rubella from an infected person who coughs or sneezes, or by sharing food or drinks with someone who is infected.
Rubella can cause serious problems for your baby if you get infected while pregnant, especially during the first three months of pregnancy.
Rubella, also called German measles, is an infection that causes mild flu-like symptoms and a rash. Up to half of people infected with rubella don’t have any symptoms and may not even know they’re infected but still spread it to other people.
If you get infected during pregnancy, rubella can cause serious problems for your baby. Infection causes the most severe damage when the pregnant person is infected early in their pregnancy, especially in the first 12 weeks (3 months).
Rubella has been nearly eliminated in the United States because of the routine vaccination of children. Vaccination protects a person against rubella for life. But people who were never vaccinated as children can get infected. You can be vaccinated as an adult when you are not pregnant.
Between 2005 and 2011, 67 cases of rubella were reported in this country. This is up from the previous period—2001 to 2004—when only 5 cases were reported. Vaccination is the best way to prevent infection. Today less than 10 people in the United States are reported to have rubella and it is usually associated with travel and not being vaccinated.
Rubella is common in many other countries. Travelers can bring it into the United States, or you can get it when traveling outside the country.
It’s important to get vaccinated for rubella. Talk to your health care provider to make sure you’re protected against it. A blood test can provide you with information about your immunity to rubella
What are the signs and symptoms of rubella?
Rubella is usually mild, with flu-like symptoms followed by a pink or light red rash. The rash usually starts on the face, then spreads to the rest of the body. The rash lasts about 3 days. Other symptoms include:
- Low-grade fever (102 F/38.9 C or lower)
- Headache
- Loss of appetite
- Runny nose
- Sore throat
- Cough
- Red eyes or pink eye (conjunctivitis)
- Swollen glands in the neck or behind the ears
- Muscle aches or joint pain
Up to 7 in 10 (70 percent) teenage and adult women who get rubella develop arthritis. Arthritis is swelling and pain in your joints. Women who are infected with rubella may feel arthritis in their fingers, wrists and knees. This complication is rare in men or children who get rubella. In rare cases, rubella can cause serious problems, including brain infections and bleeding problems.
Some people have no symptoms so you may not know that you or they have rubella.
What causes rubella?
Rubella is caused by a virus (a tiny organism that can make you sick). It is not caused by the same virus that causes measles. It’s very contagious. It spreads through the air when an infected person coughs or sneezes, or by sharing food or drinks with someone who is infected. It also can be passed to a baby from a pregnant person who is infected.
A person with rubella may spread the disease to other people up to 1 week before they notice a rash. Infected people can continue to spread the disease up to 7 days after getting a rash.
People infected with rubella should tell their friends, family, and the people they work with if they have rubella. If your child has rubella, it’s important to tell their school or daycare provider. Telling others helps prevent the spread of rubella to even more people.
What problems can rubella cause during pregnancy?
Rubella can be serious for the baby, especially during the first 3 months. Having rubella during pregnancy increases the risk of:
- Congenital rubella syndrome (CRS) – This is a condition that happens when a pregnant person passes rubella to their baby during pregnancy. It may cause your baby to be born with one or more birth defects, including heart problems, vision problems, deafness, intellectual disability, low birthweight, bone marrow problems, and liver and spleen damage. There is no cure for CRS. However, from 2005 to 2018, only 15 babies were diagnosed with CRS in the U.S., according to the Centers for Disease Control and Prevention (CDC).
- Miscarriage – This is when a baby dies before 20 weeks of pregnancy.
- Stillbirth – This is when a baby dies after 20 weeks of pregnancy.
- Preterm – This is birth that happens before 37 weeks of pregnancy.
Can you pass rubella to your baby during pregnancy?
Yes. The best way to protect your baby is to make sure you’re immune to rubella. Immune means being protected from an infection. If you’re immune to an infection, it means you can’t get the infection.
You are probably immune to rubella because you were vaccinated as a child or you had the illness during childhood. A blood test can tell if you’re immune to rubella. If you’re thinking about getting pregnant and aren’t sure if you’re immune, talk to your health care provider about getting a blood test. If you were not born in the United States or came as an adult you may not be vaccinated against rubella. Ask your health care provider to do a blood test to see if you are immune to rubella.
If you’re not immune to rubella, here’s what you can do to help protect your baby:
Before pregnancy. Get the measles, mumps and rubella (MMR) vaccine. Wait 1 month before trying to get pregnant after getting the shot.
During pregnancy. You can be tested at a prenatal visit to make sure you’re immune to rubella. If you’re not immune, the MMR vaccine isn’t recommended during pregnancy. But there are things you can do to help prevent getting infected with rubella:
- Stay away from anyone who has the infection.
- Tell your health care provider right away if you’ve been in contact with someone who is sick and may have rubella.
After pregnancy. Get the MMR vaccination after you give birth. It is safe to get the MMR vaccine while nursing. Being protected from the infection means you can’t pass it to your baby before they get their own MMR vaccination at about 12 months. It also prevents you from passing rubella to your baby during a future pregnancy.
What are the chances of passing rubella to your baby during pregnancy?
You’re more likely to pass rubella to your baby the earlier you become infected during pregnancy. For example:
- If you get rubella in the first 12 weeks of pregnancy, your baby has an 8 to 9 in 10 chance (85 percent) of getting infected. This is a very high chance.
- If you get rubella at 13 to 16 weeks of pregnancy, your baby has a 1 in 2 chance (50 percent) of being infected.
- If you get rubella at the end of your second trimester or later, your baby has a 1 in 4 chance (25 percent) of getting infected.
If you have rubella during pregnancy, your baby’s provider will carefully monitor your baby after birth to find any problems early.
How is rubella treated?
There is no specific medicine to treat rubella. In many cases, the symptoms of the disease are mild. Staying in bed (bed rest), drinking fluids and taking medicines to reduce fever can help.
Pregnant people with rubella may be treated with acetaminophen to relieve their symptoms. In more serious cases, treatment may include blood transfusion or steroids. A blood transfusion is when you have new blood put into your body. Steroids are synthetic hormones that treat inflammation.
Contact your health care provider if you are pregnant and think you have rubella or have been exposed to the disease.
See also: Your baby’s vaccinations, Vaccinations and pregnancy
Last reviewed: August 2021