What is rubella?
Rubella (also called German measles or 3-day measles) used to be a common infectious illness, which mostly affected school-age children. It is not the same as measles, which causes more severe symptoms than rubella.
What causes rubella?
Rubella is caused by a virus, which is passed from one person to another by coughing or sneezing. Rubella is highly contagious, and before the introduction of widespread immunisation there were frequent epidemics among schoolchildren.
Symptoms of rubella
Symptoms of rubella appear 14-23 days after infection.
In children, rubella symptoms include:
- a rash that generally appears on the face and scalp first and spreads to the body and arms the same day. The rubella rash fades after 2-3 days;
- a slight fever.
In older children and adults, symptoms include:
- swollen lymph glands in the neck;
- symptoms like a cold;
- rash; and
- aching joints.
For some people there will be no symptoms at all.
Tests and diagnosis
As the symptoms are so mild, rubella can be quite tricky to diagnose correctly. The only way to confirm the diagnosis is with a blood test.
Treatment of rubella
Treatment is aimed at reducing the symptoms and preventing the spread of infection. Paracetamol can be taken as directed for joint aches and fever. Drink plenty of clear fluids and rest until you feel well again.
Rubella is a notifiable disease in Australia. You or your child should not go back to school, day care or work until fully recovered or at least 4 days after the rash has started, whichever is longer. Anyone infected with rubella should also avoid contact with women of childbearing age, due to the risk to an unborn child.
What are the risks?
Serious complications of rubella infection are rare, other than in pregnant women. If a pregnant woman contracts rubella, especially in the first trimester, the virus can damage the developing baby. The baby may develop congenital heart defects, cataracts, intellectual disabilies, and deafness.
Women planning to get pregnant are encouraged to get their rubella immunity checked, and if not immune get vaccinated before they fall pregnant. Pregnant women uncertain about their immunity who come into contact with rubella should contact their doctor for advice.
Who gets rubella?
Now that many children are immunised, it is adults who may be more at risk because the effects of their childhood vaccinations may have worn off, or they may never have been vaccinated (especially males).
All children, both boys and girls, should be immunised against rubella. Rubella vaccination is free under the National Immunisation Program, using the MMR vaccine, which also immunises against measles and mumps, and the MMRV vaccine, which immunises against measles, mumps, rubella and chickenpox.
The first dose is MMR and is given at 12 months of age, and the second dose is MMRV given at 18 months of age.
Pregnancy and rubella
Women planning a pregnancy should have a blood test to see whether they are immune to rubella before they become pregnant. If they are not immune, they can be immunised but should avoid falling pregnant in the 28 days following the vaccination. Vaccination is avoided in pregnancy.
Pregnant women should be checked for rubella immunity — a routine blood test in early pregnancy. Even if the blood test carried out at a previous pregnancy proved immunity to rubella, the test must be repeated at each pregnancy. If your immunity is low, you should have an MMR vaccine shortly after giving birth. If you think you might be pregnant and your immunity has not been tested, check with your doctor.
If you are pregnant and are exposed to rubella, see your doctor as soon as possible.
2. Australian Immunisation Handbook. 4.18 Rubella. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-18 (accessed Sept 2015).
3. CDC. Rubella. Updated Dec 2014. http://www.cdc.gov/rubella/about/index.html (accessed Sept 2015).
4. NSW Health. Rubella. Aug 2013. http://www.health.nsw.gov.au/Infectious/factsheets/Pages/rubella-german-measles.aspx (accessed Sept 2015).
5. Queensland Health. Rubella. Nov 2010. https://www.health.qld.gov.au/cdcg/index/rubella.asp (accessed Sept 2015).