Rubella

Medically Reviewed by Poonam Sachdev on February 11, 2024
8 min read

Rubella is a contagious infection caused by a virus that includes symptoms like a rashfever, and eye redness. You may also hear rubella called “German measles” or the “3-day measles.”

It mostly affects children but is usually mild. Rubella can, however, cause serious conditions or be fatal to your unborn baby if you become infected during pregnancy

The best way to protect yourself and your children from infection is to get vaccinated with the measlesmumps, and rubella (MMR) vaccine.

Rubella vs. rubeola

Rubeola is another name for measles. Both rubeola and rubella are caused by viruses and have similar symptoms, including skin rash, fever,  and upper respiratory infection. Rubella, however, comes with milder symptoms than rubeola and is less contagious.

 

Rubella is usually mild in children. Sometimes it doesn't cause any symptoms.

A pink or red-spotted rash is often the first sign of infection in people with light skin tones. In people with darker skin tones, the rash may appear hyperpigmented or darker in the affected areas and rough or bumpy. The rubella rash starts on the face and spreads to the rest of the body. The rash lasts about 3 days. This is why rubella is sometimes called the "3-day measles."

Along with the rash, you or your child might have:

Rubella is caused by a virus. It used to be called "German measles," though it’s not caused by the same virus that causes measles.

Rubella spreads when someone who is infected coughs or sneezes tiny germ-filled droplets into the air and onto surfaces. If you're pregnant, you can also pass rubella to your unborn child through the bloodstream. 

People who catch the virus are contagious for up to a week before and a week after the rash appears. Some people don't know they're infected because they don't have symptoms, but they can still pass the virus to others. 

If you’ve been diagnosed with rubella, tell the people who’ve been around you, especially anyone who is pregnant. 

Until the 1960s, rubella was a common childhood infection. Thanks to the MMR vaccine, the virus stopped spreading in the U.S. around 2004. Yet it still spreads in other parts of the world. People from certain areas where the virus is still active could carry the rubella virus when they travel.

Anyone can catch rubella if they're exposed to the virus and haven't been vaccinated. Pregnant women face serious risks because rubella can cause serious complications to the baby during pregnancy, including death or serious birth defects like congenital deafness.

If your doctor thinks you have rubella, you may get blood tests and a virus culture to confirm the infection. The virus culture comes from a throat or nasal swab or from a urine sample. The blood test will show different types of antibodies in your blood.

Rubella antibodies

There are two types of rubella-specific antibodies that appear in your body after infection, including:

Rubella IgM. This antibody appears soon after you are infected with rubella or vaccinated against it. It can last in your body for up to 3 months. 

Rubella IgG. Rubella IgG occurs about 4 days after you develop the rash that comes with rubella and peaks within 1 to 2 weeks afterward. This antibody can last for a lifetime in your body.

The best time to test for the antibodies is within 5 days of having a fever or a rash, when more than 90% of cases of rubella are positive for rubella IgM.

Rubella vs. measles

Your doctor may give you a blood test or take a virus culture to confirm rubella. The presence of rubella-specific antibodies will confirm whether you're infected or were recently infected or vaccinated. With measles, your doctor would use a blood test and a throat or nose swab to confirm a diagnosis.

It’s a virus, so antibiotics won’t work.

Most of the time, the infection in children is so mild, it doesn't need to be treated. You can bring down your child's fever and ease aches with pain relievers like children's acetaminophen or ibuprofen. Don't give your child or teen aspirin because of the risk for a rare but serious condition called Reye's syndrome, which causes swelling in the brain and liver.

If you’re pregnant and think you’ve caught rubella, call your doctor right away. You may be able to take antibodies called hyperimmune globulin to help your body fight the virus.

As for home remedies for rubella, there aren’t any that make the virus go away faster. But rest and pain relievers can help with self-care in mild cases, if needed.

It's best to be protected against rubella before you get pregnant, as getting infected during your first trimester can cause serious conditions or even death in your unborn baby. In fact, the most common cause of congenital deafness is rubella infection during pregnancy.

Some women who get rubella during pregnancy have a miscarriage. In other cases, the baby doesn't survive long after birth.

If you are planning to become pregnant, check your vaccination records to confirm you have received the MMR vaccine (the second and last recommended vaccination dose is given between the ages of 4 and 6 years). You should wait at least 4 weeks after getting the vaccine to become pregnant. If you’re already pregnant, you shouldn’t get the vaccine.

While you're pregnant, you'll go through a routine screening to check for rubella immunity during pregnancy. If you're not sure whether you've had the MMR, tell your doctor immediately. They can use a blood test to check your immunity.

Congenial rubella syndrome (CRS)

Congenital rubella syndrome (CRS) is a condition that happens when a child becomes infected with the rubella virus via their mother during pregnancy. If you're infected with rubella during early pregnancy, you could have a miscarriage or your baby could be stillborn, born with birth defects, or hearing impairment. The risk of your baby being infected with the rubella virus and being born with serious associated conditions is greatest during your first trimester of pregnancy (through week 12) and decreases afterward (rare after the 20th week).

If your child has CRS, they often have more than one serious condition, the most common of which include developmental delay, cataracts, congenital heart disease, and hearing impairment. It's possible for children with CRS to have only one condition; if this is the case, they usually have hearing impairment.

The most serious complications could happen during pregnancy, when the virus can pass from you to your baby in the womb. The risk is highest during the first 3 months of pregnancy.

Babies who are infected can have serious conditions at birth like CRS. This is very rare in the U.S., but a baby can get it if they travel to another country where the virus spreads.

CRS health problems in a baby can include: 

Rubella can also cause complications in women who aren't pregnant, and in men. Young girls and women who get it can develop sore joints (arthritis). This side effect usually goes away within 2 weeks, but a small number of women will have it long term. It rarely happens in men and children.

In rare cases, rubella can cause more serious health problems, like brain infections or swelling and bleeding problems.

The best way to prevent rubella is to get vaccinated. Children need two doses of the MMR vaccine. They should get the first when they’re between 12 and 15 months old. They should get the second between 4 and 6 years old.

Babies who’ll be traveling to a country where rubella is common can get vaccinated as early as 6 months old.

If you're of childbearing age and you haven't been vaccinated, get the MMR vaccine at least 1 month before you get pregnant. This is most important if you plan to travel to countries where rubella spreads.

Rubella vaccination

Vaccination against rubella is normally provided as a combination vaccine, called the MMR (measles-mumps-rubella) vaccine. It could also include the vaccine against chickenpox (varicella), which is called the MMRV vaccine. It's recommended that children get the vaccine between 12 and 15 months of age and again between ages 4 and 6 years.

When you get the vaccine, you're protected against rubella for life. 

If you've received the vaccine and have a baby, your baby is protected against rubella for 6 to 8 months. Getting the vaccine can prevent rubella during future pregnancies.

Rubella is a contagious disease that mostly affects children and causes symptoms like a rashfever, and eye redness. It’s usually mild in kids but can be serious during pregnancy and in unborn babies.

The best way to protect yourself and your children from infection is to get vaccinated with the measlesmumps, and rubella (MMR) vaccine to avoid long-term complications.

  • What are the long term effects of rubella? Some women or people assigned female at birth may have arthritis.
  • What happens if a pregnant woman is exposed to rubella? If you're pregnant and are not vaccinated, your unborn baby is at risk for health concerns like growth delays, deafness, and developmental issues. Some people who get rubella during pregnancy have a miscarriage. In other cases, the baby doesn't survive long after birth.
  • When are you contagious with rubella? If you have rubella, you're contagious for about 1 week before the rash begins to 1 week after the rash disappears.
  • How is the rubella virus transmitted? The rubella virus can be passed when an infected person coughs or sneezes or when contact is made with mucus from their nose or throat. People who are pregnant can pass it on to their child through their blood.