What is rubella?

Rubella is an infectious viral disease. It is also known as 'three-day measles' or 'German measles', although it is not measles at all. Rubella is generally a mild illness and goes away by itself after a few days. There is no specific treatment for rubella. However, if a pregnant mother is infected, she can pass the virus on to her baby, which can cause death or serious birth defects for the child. A rubella vaccine is available and is given to children at the scheduled 12-month and 18-month immunisations, as well as to adults who require it.

Rubella used to be common and widespread throughout the world. Since the introduction of the rubella vaccine in the 1960s, the rates of rubella infection have dropped dramatically. However, it is still found in countries where the rubella vaccination rate is low, causing over 100,000 serious birth defects worldwide each year. [1] [2]

Vaccine

A preparation containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.

Viral

Pertaining to an illness caused by a virus.

Virus

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Causes

Rubella is caused by the rubella virus (not to be confused with the rubeola virus, which causes measles).

When an infected person sneezes or coughs, the virus spreads via millions of tiny droplets into the air, each containing many viruses. If a droplet enters your nose or mouth, you may then become infected with the virus. The droplets can also collect on surfaces and objects, so you can also catch the virus by touching an infected surface and then touching your nose or mouth area.

Virus

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Risk factors

Anyone can catch the rubella virus if they have not been infected or vaccinated in the past. The risk of infection for people who have had the rubella immunisation is low.

Virus

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Signs and symptoms

Symptoms of rubella are generally mild, if they appear at all. About half of the people who contract rubella feel no symptoms at all. The incubation period between infection and when symptoms first appear can be 2-3 weeks. Symptoms can include:

  • Mild to moderate fever;
  • Runny nose;
  • Reddish, watery eyes;
  • Swollen lymph nodes;
  • Muscle and joint pain;
  • Pinkish or reddish rash, and;
  • Malaise - a feeling of weakness and discomfort.

Symptoms normally go away naturally after a few days. An infected person can infect other people for a week before and for a week or two after symptoms appear. The person is most contagious in the period when they have the rash.

The rubella rash is caused by infection with the rubella virus.The rubella rash. 
 

Contagious

A disease that can be passed on from person to person.

Fever

An increase in body temperature above the normal temperature range. Fever is often caused by the body's immune reaction to infection.

Lymph nodes

A small organ of the lymphatic system containing many immune cells. Lymph nodes, also known as lymph glands, are the sites where many interactions between immune cells and foreign materials occur.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Methods for diagnosis

Your doctor will diagnose rubella by noting the symptoms. Blood tests and a nose or throat swab (checking for the presence of the virus or antibodies against it) can be used to confirm the diagnosis.

Antibodies

A protein molecule produced by the immune system. Antibodies bind specifically to foreign substances to neutralise them or target them for destruction.

Blood tests

During a blood test, blood can be drawn using a needle or by a finger prick. Your blood can then be analysed to help diagnose and monitor a wide range of health conditions.

Virus

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Types of treatment

There is no specific treatment for rubella. Treating a rubella patient focuses on relieving some of the symptoms while the patient's immune system handles the disease. Some measures that can be taken to ease the effect of rubella symptoms are:

  • Rest;
  • Medicines to reduce fever, and;
  • Drinking plenty of fluids to prevent dehydration.

Dehydration

The state of insufficient hydration; excessive loss of water; requiring more water in order to function normally.

Fever

An increase in body temperature above the normal temperature range. Fever is often caused by the body's immune reaction to infection.

Immune system

The organs and cells involved in protecting the body against infection.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Potential complications

Congenital rubella

The most serious complication of rubella is congenital rubella. It occurs when a pregnant woman contracts the virus and passes it on to her unborn child. The child is then at risk of dying in the uterus, or developing serious birth defects.

There is up to a 90% chance of congenital rubella infection when the mother is infected with the virus either during the first 20 weeks of pregnancy, or possibly shortly before conception. [1]  If the mother catches the disease later in the pregnancy, she has less chance of passing on the disease to the baby. [2]

Congenital rubella can most often cause defective development of the eyes, ears, heart and the nervous system and brain. 

Arthralgia

A form of joint inflammation, known as arthralgia, can appear in some people who have been exposed to rubella or the rubella vaccine, especially adult women. It causes pain and inflammation in the body's joints. The condition usually goes away after 2-3 days, but in some cases can last up to a month.

Nervous system

The extensive network of cells and structures that is responsible for activating and coordinating the body's functions, sensory input and cognition.

Vaccine

A preparation containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.

Virus

A microscopic infectious agent that replicates itself only within cells of living hosts; a piece of nucleic acid (DNA or RNA) wrapped in a protein coat.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Prognosis

If there are no complications, rubella clears up on its own after a few days.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.

Prevention

A rubella vaccine is available and given routinely to children, usually from 12 months of age, as a childhood immunisation. If a rubella outbreak occurs in the community, younger children may be offered the vaccine.

The vaccine is also available for older children and adults. It is not recommended for pregnant women. Women preparing for pregnancy are routinely offered a blood test to check whether they are immune to rubella. If the results indicate that the woman is not immune, she will be offered vaccination to protect her and her baby during pregnancy and also advised to delay getting pregnant for at least one month after vaccination.

Blood test

During a blood test, blood can be drawn using a needle or by a finger prick. Your blood can then be analysed to help diagnose and monitor a wide range of health conditions.

Vaccine

A preparation containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.

1. Banatvala J. and Brown D. (2004) Rubella. The Lancet 363:1127–1137.

2. Babigumira J.B. Morgan I. and Levin A. (2013) Health economics of rubella: a systematic review to assess the value of rubella vaccination. BMC Public Health 13:406.