Rubella (German Measles)
What is it?
Rubella (German measles) is a highly contagious disease caused by a virus which first affects the cells of the nose and throat and then spreads to the lymph glands in the neck. For most children and adults, rubella is a mild illness. Rarely, rubella can cause inflammation of the brain.
Rubella is very dangerous for a developing baby. If a pregnant woman is infected early in pregnancy there is a high risk for miscarriage, stillbirth and birth defects called congenital rubella syndrome (CRS). CRS occurs in up to 90% of infants born to women infected with rubella during the first trimester. The risk is 10-20% by the 16th week of gestation and is rare when the mother is infected after the 20th week of gestation. The most common disabilities are blindness, deafness, mental impairment and heart defects.
The incidence of rubella has declined in Ontario since a two-dose MMR vaccination program was introduced in 1996. Cases of rubella generally occur in young un-immunized children or older children, adolescents and adults who received only one dose of the vaccine.
How is it spread?
The virus is spread from person to person through direct contact with nose and throat secretions of an infected person or when droplets are inhaled from someone infected with rubella who coughs or sneezes. Rubella is contagious from 7 days before the rash appears and at least 4 days after. Babies born with congenital rubella syndrome can spread the virus in their nose and throat secretions as well as their urine for months after birth.
What do I look for?
Up to half of children and adults infected with rubella don’t develop any symptoms. For those with symptoms, rubella is usually a mild illness with low fever, headache, tiredness, red eyes, runny nose, joint pains, swollen and tender glands and/or rash. Joint pain is more common in adults, especially women. The swollen glands are usually behind the ears and at the back of the head. The rash is red, faint and can be itchy. It usually begins on the face and spreads down to the feet within 24 hours and lasts 1-3 days. Symptoms develop 2 to 3 weeks after coming into contact with someone infected with rubella.
How is it treated?
There is no treatment for rubella and symptoms usually resolve on their own. Antibiotics are not effective because the disease is caused by a virus. If you are diagnosed with rubella, you must remain isolated at home for 7 days after your rash first appears. Babies with congenital rubella syndrome are considered infectious for months after birth and must be carefully followed by a doctor.
How can I protect myself?
- Rubella is best prevented by vaccination.
- See Facts About….Measles, Mumps, Rubella Vaccine.
- Keep up to date with vaccinations and speak to your doctor/health care provider about your need for other vaccines.
- Wash your hands thoroughly with soap and water or use hand sanitizer when hands are not visibly dirty.
- Cough or sneeze into your elbow and encourage others to do the same.
- Wash your hands after handling nose and throat discharges (i.e., after disposal of facial tissues containing nose and throat discharges).
- Do not share water bottles, straws, eating utensils, cigarettes, toothbrushes, toys or anything else that has been in contact with saliva, nose or throat secretions.
- If you are ill, stay at home and isolate yourself from others, especially pregnant women.