Rubella – Symptoms and Causes

Overview

Rubella, also known as German measles or three-day measles, is a viral infection. It is characterized by a distinctive red rash. Most people experience mild symptoms or none at all.

However, the virus poses serious risks to unborn babies when pregnant women become infected.

Rubella differs from regular measles. Both illnesses cause red rashes, but they stem from different viruses. Rubella is generally less contagious and less severe than measles.

The infection causes a fine, pink rash that typically appears first on the face, then spreads to the trunk of the body, and finally reaches the arms and legs.

The most effective protection against rubella is the measles-mumps-rubella (MMR) vaccine. This safe and highly effective vaccine provides lifelong immunity against the virus.

Due to widespread vaccination programs, rubella has become rare or even nonexistent in many countries. However, since the vaccine isn’t used universally worldwide, the virus continues to cause serious complications for babies whose mothers contract rubella during pregnancy.

Symptoms

Rubella can be hard to spot, especially in kids. People usually start showing signs 2-3 weeks after getting the virus. Symptoms typically last 1-5 days.

Common symptoms include:

• Low-grade fever (up to 102°F or 38.9°C)
• Headache
• Congested or runny nose
• Red, itchy eyes
• Swollen, sore lymph nodes near the skull base, neck back, and behind ears

A distinctive pink rash appears first on the face, then spreads to the trunk, arms, and legs. The rash fades in the same order it appeared.

Joint pain is another symptom, occurring more frequently in young women.

When to See a Doctor

Call your healthcare provider if you think you or your child may have been exposed to rubella, or if you notice any symptoms of the disease.

For Women Planning Pregnancy:

• Check your vaccination record for the measles-mumps-rubella (MMR) vaccine
• Get vaccinated before becoming pregnant if you aren’t already immune
• Being protected before pregnancy is important for your baby’s health

During Pregnancy:

• Contact your doctor immediately if you’re pregnant and think you’ve been exposed
• Rubella during pregnancy, especially in the first trimester, can cause:
  • Serious birth defects
  • Fetal death
  • Congenital deafness (the most common complication)

Most pregnant women receive routine screening for rubella immunity. If you haven’t been vaccinated and suspect exposure, your doctor can perform a blood test to confirm whether you’re already immune.

Causes

Rubella spreads through a virus that moves from person to person. When someone with the infection coughs or sneezes, tiny droplets containing the virus can travel through the air.

People can also catch rubella through direct contact with infected nose or throat mucus.

Pregnant women can pass the virus to their unborn babies through the bloodstream. This is particularly dangerous and can lead to serious birth defects.

A person with rubella can spread the disease before and after symptoms appear:

• Before Symptoms: Contagious about one week before the rash appears.
• After Symptoms: Remains contagious until about one week after the rash fades.

This means people often spread rubella before they know they have it.

In many countries, rubella has become rare because of widespread vaccination programs for children. However, the virus remains active in parts of the world where vaccination is less common. Travelers should consider this risk, especially pregnant women.

After recovering from rubella, most people develop permanent immunity to the disease.

Complications

Rubella generally causes a mild infection. Women who have had rubella may experience joint pain, particularly in fingers, wrists and knees. This pain typically lasts about one month. Rarely, rubella can lead to ear infections or brain inflammation.

The most serious concerns arise when rubella affects pregnant women. The virus can severely impact unborn babies, sometimes with fatal outcomes.

When mothers contract rubella during the first 12 weeks of pregnancy, up to 90% of their infants develop congenital rubella syndrome.

This syndrome may cause several serious problems:

• Growth delays
• Eye problems (cataracts)
• Hearing loss (deafness)
• Heart defects
• Poor organ development
• Intellectual disabilities

While the first trimester presents the highest risk, exposure during later pregnancy stages remains dangerous for the developing baby. These potential complications highlight why vaccination and prenatal care are essential preventive measures.

Preventing Rubella

Many parents worry about a possible connection between the MMR vaccine and autism.

Research from leading health organizations, including the American Academy of Pediatrics and the Centers for Disease Control and Prevention, has found no scientific evidence linking the vaccine to autism.

Autism is often first noticed in children between 18-30 months old, which happens to be around the same time children receive their first MMR vaccine. This timing is coincidental, not causal.

Who Needs the MMR Vaccine?

You don’t need the MMR vaccine if you:

• Received two doses after 12 months of age
• Have blood test results showing immunity to measles, mumps and rubella
• Were born before 1957 (though vaccination is still recommended without blood test confirmation)

You should get vaccinated if you haven’t had two doses after age 12 months or lack blood test evidence of immunity.

Vaccination is particularly important if you:

• Are a woman of childbearing age who isn’t pregnant
• Attend college or trade school
• Work in healthcare, education, or childcare settings
• Plan to travel internationally or go on cruises

The vaccine isn’t recommended for:

• Pregnant women or those planning pregnancy within four weeks
• People with severe allergic reactions to gelatin, neomycin, or previous MMR doses

Special considerations: If you have immune system disorders, cancer, or take medications affecting immunity, consult your doctor before vaccination.

Possible Vaccine Side Effects

Most people experience no side effects from the MMR vaccine. When side effects occur, they typically appear about two weeks after vaccination and are usually milder after the second dose.

Common mild side effects include:

• Soreness at the injection site
• Low-grade fever
• Mild rash or redness where the shot was given

Less common side effects include:

• Temporary joint pain (especially in teen girls and women)
• Swollen glands in neck or cheeks
• Fever-related seizures
• Temporary drop in platelet count
• Widespread rash

Serious allergic reactions are extremely rare.

After Being Diagnosed With Rubella

If you’re diagnosed with rubella, tell people you’ve been in contact with to protect them from infection. This includes:

1. Family members who share your home
2. Close friends you’ve recently seen
3. Coworkers who might have been exposed

Parents should notify schools or childcare centers if their child has rubella. This helps protect other children and staff, especially pregnant women who might be at risk.

Healthcare providers can advise on how long to stay home to avoid spreading the infection. Following their guidance helps protect vulnerable people in your community, particularly pregnant women for whom rubella poses serious risks.