Rubella (German Measles)


Rubella, also known as German measles, is an infectious disease caused by a virus. The virus is spread through droplets of moisture from the nose or throat of someone who is infected.

Rubella can be caught from face-to- face contact with someone who has the disease or even by being in the same room.

Rubella causes a red rash and a high temperature.

For most people it is a mild disease, but it can have serious consequences for pregnant women.

Rubella used to be common in children, but since the introduction of a vaccination programme in the 1980s, the disease has been almost entirely eradicated.

Rubella remains a notifiable disease under the Public Health (Infectious Diseases) Regulations 1988. This means that any doctor who diagnoses the infection must, by law, inform the local authority. This is to identify the source of the rubella infection and stop it spreading.

What happens if I get rubella?

The main symptoms of rubella are a rash which is a distinctive red-pink colour. It starts as spots, which can be itchy, before spreading from behind the ears to the head and neck and then other parts of the upper body. The rash usually lasts for up to a week.

Other main symptoms are swollen lymph glands around the ears and back of the head, a high temperature of 38C or more and cold-like symptoms.

Other less common symptoms in adults are arthritis and arthralgia ( pain in a joint caused by inflammation).

In rare cases rubella can lead to serious complications. In one in 6,000 cases it can lead to inflammation of the brain; in one in 3,000 cases it can affect blood clotting.

The incubation period for rubella is 14 to 21 days, with most people developing a rash between 14 and 17 days after exposure.

In most cases rubella is a mild condition, but if you suspect you have the disease you should contact your doctor to have it confirmed. Phone the surgery, rather than visit, in case there are pregnant women in the waiting room.

Rubella can be diagnosed with a blood test.

Stay away from work and keep a child off school until you have consulted a doctor.

Why can rubella be dangerous if you are pregnant?

Some pregnant women will have immunity to rubella, either from having had the disease in the past or from being vaccinated. However, if a pregnant woman who does not have immunity catches the virus, she can pass it on to her unborn child.

The virus can cause a number of birth defects known as congenital rubella syndrome (CRS). Defects include mental handicap, cataract, deafness, heart abnormalities and slower than normal foetal growth.

The risk of a baby being affected by CRS and the severity of the birth defects depends on the mother’s stage of pregnancy when she catches the rubella virus.

Before 11 weeks of pregnancy the risk is 90%
Between the 11th and 16th weeks of pregnancy the risk is 10-20%
Between 16 and 20 weeks there is a minimal risk of deafness only
After 20 weeks there is no increased risk of abnormalities

Why can rubella be dangerous if you are pregnant? continued…

Pregnant women should see a GP if they have had face-to-face contact with someone who has rubella or if they have spent more than 15 minutes in the same room as someone with rubella. Tests may be carried out if you have not been immunised against rubella and you may be referred to an obstetrician for further tests to check whether your baby has CRS. An ultrasound scan and amniocentesis may be able to determine the type and extent of any birth defects.

Patients may be offered counselling so they can make an informed decision about whether to proceed with a pregnancy in cases where birth defects are confirmed.

How is rubella treated?

Cases of rubella are usually mild and there is no specific treatment for the condition.

Symptoms usually clear up within a week to 10 days and there is no need to treat the rash.

Paracetamol or ibuprofen can be used to reduce fever and ease any aches and pains. Age-appropriate paracetamol or ibuprofen can be used for young children.

Drink plenty of fluids.

How can rubella be prevented?

The most effective way of preventing rubella is to be immunised with the measles, mumps and rubella (MMR) vaccine.

The MMR vaccine is given to children as part of the routine vaccination programme. The first dose is given at around 12-13 months and a second dose before they start school, usually between three and five years of age.

Women who are planning to have a baby can ask their doctor for an immunity test. Those with no or few rubella antibodies will be offered the MMR vaccine. The vaccine can be administered at any time up to one month before getting pregnant. The NHS says that it is safe for breastfeeding mothers to have the MMR vaccine.

If you think your immunisation many not be up to date, and you are at risk of getting the rubella virus, you can ask for the MMR vaccine at any time.

A single vaccine to protect against rubella is no longer available.