Rubella

Alternate names

German measles; Three day measles

Definition

Rubella is a viral illness that can lead to complications and death. It is characterized by a mild, maculopapular rash along with lymphadenopathy, and a slight fever. Congenital rubella is when a pregnant woman with rubella passes it to the baby that is still in her womb.

Cause

Rubella virus is an enveloped, positive-stranded RNA virus classified as a Rubivirus in the Matonaviridae family.

Transmission

• Rubella spreads when an infected person coughs or sneezes. Also, if a woman is infected with rubella while she is pregnant, she can pass it to her developing baby and cause serious harm.
• A person with rubella may spread the disease to others up to one week before the rash appears, and remain contagious up to 7 days after.
• However, 25% to 50% of people infected with rubella do not develop a rash or have any symptoms, but they still spread it to others.

Signs and symptoms

In children, rubella is usually mild, with few noticeable symptoms. For children who do have symptoms, a red rash is typically the first sign. The rash generally first appears on the face and then spreads to the rest of the body, and lasts about three days.

Other symptoms that may occur 1 to 5 days before the rash appears include:

• a low-grade fever
• headache
• mild pink eye (redness or swelling of the white of the eye)
• general discomfort
• swollen and enlarged lymph nodes
• cough
• runny nose

• Most adults who get rubella usually have a mild illness, with low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body.
• Some adults may also have a headache, pink eye, and general discomfort before the rash appears.
• About 25 to 50% of people infected with rubella will not experience any symptoms.

Diagnosis

Healthcare providers should

• consider rubella in unvaccinated patients with febrile rash illness and other rubella symptoms, especially if the person recently traveled internationally or was exposed to a person with febrile rash illness
• promptly isolate people suspected to have rubella and report them to the local health department
• collect throat (best source), nasal, or urine specimens for viral detection by polymerase chain reaction (PCR) testing and molecular typing, and blood for serologic testing.

Treatment

There is no specific medicine to treat rubella or make the disease go away faster. In many cases, symptoms are mild. For others, mild symptoms can be managed with bed rest and medicines for fever, such as acetaminophen.

Complications

Up to 70% 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. The most serious complication from rubella infection is the harm it can cause a pregnant woman’s developing baby. If an unvaccinated pregnant woman gets infected with rubella virus she can have a miscarriage, or her baby can die just after birth. Also, she can pass the virus to her developing baby who can develop serious birth defects such as—

• heart problems,
• loss of hearing and eyesight,
• intellectual disability, and
• liver or spleen damage.
• Serious birth defects are more common if a woman is infected early in her pregnancy, especially in the first trimester. These severe birth defects are known as congenital rubella syndrome (CRS).

Vaccination

• Rubella can be prevented with MMR vaccine.
• This protects against three diseases: measles, mumps, and rubella.
• CDC recommends children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination.
• MMR vaccine is very safe and effective.
• One dose of the MMR vaccine is about 97% effective at preventing rubella.

NIH genetic and rare disease info

• NIH info on Rubella

Rubella is a rare disease.

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  Cataracts due to Congenital Rubella Syndrome
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  Rubella virus TEM image