Rubella [ro͞oˈbel-uh] is a contagious disease caused by a virus. It is usually mild in children, with fever and a rash. In pregnant women, rubella infections can cause serious birth defects. Rubella is preventable with the MMR vaccine.
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Table of Contents for Rubella
How do you get rubella?
How many people get rubella every year?
What are the symptoms of rubella?
How soon do symptoms appear?
What are complications of rubella?
Is rubella contagious?
How is rubella treated?
Why do we use MMR instead of MMRV for rubella?
How effective is the rubella vaccine?
What is the immunization schedule for rubella?
What are rubella vaccine names?
Rubella is a contagious viral disease that causes a rash and fever. It is also called German measles or three-day measles. Rubella is not the same as measles (rubeola), but the two illnesses share some common characteristics, such as a rash. Rubella is usually a mild disease in children that can be prevented with a vaccine. For pregnant women, rubella infections can cause fetal death or severe birth defects.
The rubella virus usually spreads in airborne droplets when an infected person sneezes, coughs, breathes, or talks. Anyone who is not immune to rubella can get the disease by breathing virus-infected fluid or sharing food and drinks with some one who is infected. The rubella virus can also infect the unborn baby of a pregnant woman.
From 2005 through 2011, an average of 11 rubella cases was reported each year in the United States. Before the rubella vaccine was introduced in 1969, up to 4 babies out of every 1,000 live births had Congenital Rubella Syndrome (CRS). Large-scale vaccination programs have almost eradicated rubella in developed countries, but worldwide, over 100,000 babies are born with CRS every year.
Rubella usually causes a mild rash and other symptoms in children . The rash occurs in 50-80% of people and it usually starts on the face and neck before spreading to the body. The rash lasts for 1 to 3 days and usually clears up without long-term scarring.
Not everyone has symptoms of rubella. If they appear, symptoms may include:
- Rash (pink or light-red spots, patches)
- Low fever
- Stuffy or runny nose
- Mild conjunctivitis (eye inflammation)
- Swollen lymph nodes behind the ears and neck
- Arthritis and joint pain in adults (lasts 3-10 days)
The symptoms of rubella may not appear for 2 to 3 weeks after exposure to the virus. The average incubation period is 16-18 days.
Pregnant women who are infected with the rubella virus have a 90% chance of passing the virus to their unborn baby. This can cause miscarriage, stillbirth, or a devastating birth defect known as Congenital Rubella Syndrome (CRS).
Pregnant women who are infected with rubella in the first 12 weeks of pregnancy (1st trimester) have a 1 in 5 chance of having problems with the pregnancy. Infants who are born with CRS may excrete the virus for a year or more.
Babies with CRS are at risk of the following complications:
- Autistic disorders
- Growth problems
- Intellectual disability
- Hearing impairments
- Eye defects
- Heart defects
- Thyroid dysfunction
- Liver, spleen, and bone marrow problems
Yes. Rubella is most contagious from 1 week before the rash appears to 1 week afterward. It is most highly contagious 1-5 days after the rash appears. People without symptoms are still contagious.
Infants who are born infected with rubella are contagious for a year or more. They continuously shed the virus in their urine and fluids from their nose and throat. People who are not immune to rubella who come in contact with these fluids can become infected.
There is no specific treatment for rubella because it is caused by a virus, so antibiotics will not cure the infection. Treatment focuses on alleviating symptoms until the body’s immune system kills the virus.
The rubella vaccine is a live virus that has been attenuated (weakened). The same strain of the virus has been in use since the vaccine was introduced in 1969. The vaccine against rubella is combined with vaccines against measles and mumps. It is called the MMR vaccine.
Another vaccine called MMRV combines the MMR vaccine with Varicella (chickenpox). The MMRV vaccine ProQuad® was discontinued and is no longer recommended. Instead, doctors recommend the MMR vaccine because the MMRV vaccine doubles a child’s risk of fever-induced seizures (febrile seizures). The risk is approximately 1 in 1,250 for MMRV compared to 1 in 2,500 for the MMR vaccine.
A single dose of the rubella vaccine is more than 95% effective at providing long-lasting immunity to rubella. The effectiveness is similar to the immunity provided by a natural infection with rubella.
Children should receive two doses of the MMR vaccine (Measles-Mumps-Rubella) at the following ages:
- 1st dose: 12 through 15 months
- 2nd dose: 4 through 6 years old
The rubella vaccine should not be given to pregnant women, or women who might become pregnant within 1 month of the vaccine. Women who are pregnant should wait until after they have given birth to get the MMR vaccine if they are not already immune to rubella.
Women who are planning on becoming pregnant should get a pre-pregnancy blood test to check if they are immune to rubella. If they are not immune, they should avoid becoming pregnant until 28 days after the MMR vaccine, and after another blood test to confirm immunity.
- M-M-R-II® (MMR Vaccine)
- ProQuad (MMRV Vaccine)
Yes. Side effects of the rubella vaccine are generally mild. The risk of a severe allergic reaction is less than 1 out of a million doses. Symptoms may include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness within a few minutes to a few hours after the vaccination.
To learn more about the side effects associated with the rubella vaccine, please visit this page: Rubella Vaccine Side Effects.
The most common side effects of the rubella vaccine are pain and redness where the shot was injected, low-grade fever, rash, muscle aches, and swelling of glands in the cheeks and neck. About 25% of adult women who receive the MMR vaccine develop temporary joint pain, a symptom of the rubella component of the combined vaccine.
The MMR vaccine has been associated with the following severe side effects:
- Shoulder Injury Related to Vaccine Administration (SIRVA)
- Seizures caused by high fevers
- Temporary pain and stiffness in the joints
- Temporary low blood platelet count, which can cause a bleeding disorder
- Serious allergic reaction
- Long-term seizure disorder
- Lowered consciousness
- Brain damage