Rubella

Overview

Rubella, also called German measles, is a mild viral infection that causes a red or pink rash. It is most concerning for pregnant women, because it can harm the unborn baby.

Rubella is now rare in countries with routine vaccination. It still occurs in some parts of the world where vaccination is not widespread.

It mainly affects unvaccinated children and young adults. Pregnant women who are not immune are the group most at risk.

Symptoms

Common symptoms

• Mild fever
• Red or pink rash that starts on the face and spreads downward
• Swollen glands, especially at the back of the neck
• Runny nose or stuffy nose
• Sore throat
• Headache
• Aching joints

Symptoms in children

• The illness is often very mild.
• Some children have no symptoms at all.
• The rash may be the only sign.

Symptoms in older adults

• Adults may have a more noticeable fever and tiredness.
• Joint pain is more common, especially in women.
• Symptoms can last a few days longer.

Causes

Main causes

• Rubella is caused by the rubella virus.
• It spreads through droplets in the air when an infected person coughs or sneezes.
• It can also spread by touching surfaces or sharing cups and cutlery with an infected person.

Risk factors

• Not being vaccinated against rubella
• Living or working with unvaccinated people
• Travelling to countries where rubella is still common
• Being pregnant and not immune to rubella

When to see a doctor

See a doctor urgently if:

• Contact a healthcare provider immediately if you are pregnant and may have been exposed to rubella
• Seek same-day advice for a baby under 3 months with a rash and fever
• See a doctor urgently if you have a rash and a high fever or severe headache

Book a routine appointment if:

• Make a routine appointment if you have a rash that you are unsure about
• If you are planning a pregnancy and do not know your rubella immunity, ask to be tested
• Before travelling, ask your healthcare provider if you are fully vaccinated

Diagnosis

A doctor can often suspect rubella from the rash and other symptoms. To confirm it, they may arrange a blood test or a swab from the throat or nose.

Tests that may be done

• Blood test to check for rubella antibodies
• Throat or nose swab to detect the virus
• Blood tests during pregnancy may check if you are immune

What to expect at your appointment

The doctor will ask about your symptoms, vaccination history, and any contact with someone with a rash. They may report the case to local health authorities. Test results may take a few days.

Treatment

There is no specific cure for rubella. Treatment focuses on easing symptoms and preventing spread. Most people recover with rest and home care.

Self-care at home

• Rest and sleep as much as needed
• Drink plenty of fluids
• Use over-the-counter pain and fever relief as advised by your pharmacist
• Do not give medicine to a child under 16 without checking with a pharmacist or doctor
• Stay away from work, school, or nursery for at least four days after the rash starts
• Avoid contact with pregnant women until you are fully recovered

Medical treatments

For most people, no medical treatment is needed. In rare severe cases or for pregnant women, doctors may provide supportive care in hospital. No routine antiviral medicine is used for rubella.

Living with this condition

While you have rubella, stay home and rest. Keep away from others, especially pregnant women and babies. Let close contacts know so they can check their vaccination status.

Lifestyle tips

• Cover your mouth and nose with a tissue when coughing or sneezing
• Wash your hands often with soap and water
• Toss used tissues in a bin immediately
• Avoid sharing cups, cutlery, and towels until the rash has gone

Diet and exercise

Eat a normal, balanced diet and drink plenty of fluids. Gentle movement can help you feel better once the fever goes, but do not exercise until you are fully recovered.

Mental health and emotional wellbeing

Being at home and away from others can feel lonely, but it is important to prevent spreading the infection. If you feel anxious or worried, talk to a friend, family member, or healthcare professional.

Prevention

Yes. Rubella can be prevented with vaccination and by avoiding close contact with infected people. The best protection is the routine childhood vaccine.

Vaccines

The combined MMR vaccine protects against measles, mumps, and rubella. Two doses are usually given in childhood. If you are unsure about your vaccination history, ask your healthcare provider about checking or completing the schedule.

Screening programmes

In pregnancy, routine blood tests check whether you are protected against rubella. If you are not immune, your doctor will advise you to avoid exposure and to get vaccinated after the baby is born.

Complications

If left untreated

• In pregnancy, rubella can cause serious birth defects such as hearing loss, vision problems, heart defects, and learning difficulties
• In rare cases, rubella can cause brain inflammation (encephalitis)
• Some people may develop low blood platelets, which increases the risk of bleeding

Long-term outlook

Most people recover fully within a week. With good care and vaccination, rubella and its complications are almost entirely preventable. For pregnant women who are not immune, early medical support can make a very positive difference.

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