Rubella (German measles)

Commonly known as German measles or 3-day measles

Rubella is a viral illness that causes a skin rash and joint pain. It mostly affects school-age children and is a mild disease, but when it occurs during pregnancy, it can have harmful effects for an unborn baby, such as deafness, blindness, heart defects and brain damage.

Key points

  1. Rubella (also called German measles) is a different disease to measles (also called English measles).
  2. It is spread through the air when someone ingests (swallows) or inhales (breathes in) the cough or sneeze droplets from an infected person.
  3. In most people, the symptoms of rubella are mild, such as fever, headache, joint pain and skin rash. Often there are no symptoms.
  4. If a pregnant woman contracts rubella, her baby is at risk of severe and permanent birth defects or death.
  5. Vaccination with the combination measles, mumps and rubella (MMR) vaccine is the best way to protect against rubella. No rubella-only vaccine is available in New Zealand. In New Zealand, the vaccine is free for all unvaccinated people, or those with an unknown immunisation history.
  6. Pregnant women should not be given the MMR vaccine. If you are planning a pregnancy, ask your midwife or doctor if you need to be vaccinated against rubella so that your baby is protected. When you have been vaccinated, you should avoid getting pregnant for at least a month afterwards.

What causes rubella?

Rubella is caused by the rubella virus, which is spread through the air when someone ingests (swallows) or inhales (breathes in) the cough or sneeze droplets from an infected person. An infected person is contagious from 7 days before the rash appears to 7 days afterwards. You are most contagious when the rash is erupting. You should avoid attending childcare facilities, school, work or other public places until you are well or for 7 days after the appearance of the rash.

What are the symptoms of rubella?

The main symptoms of rubella are fever, rash, aching and swollen joints, and swollen glands in your neck. The rash begins on your face and spreads to your neck, body, hands and legs. It appears as pink or light red spots. It lasts up to 5 days (the average is 3 days). It may or may not be itchy. As the rash fades, the affected skin may shed in flakes. For some people there will be no symptoms at all. As the symptoms are so mild it can be quite tricky to diagnose correctly. The only way to confirm the diagnosis is with a blood test.

Pregnancy

If a pregnant woman contracts Rubella, especially during the first 3 months of her pregnancy, she is at increased risk of having a miscarriage, or the unborn baby is at risk of developing severe abnormalities (referred to as congenital rubella syndrome), which include cataracts, deafness, heart abnormalities, intellectual disability and behavioural problems.

  • Pregnant women are checked for rubella immunity via a blood test in early pregnancy. Even if the blood test from a previous pregnancy showed immunity to rubella, the test must be repeated at each pregnancy.
  • If you think you might be pregnant and your immunity has not been tested, check with your doctor or practice nurse.
  • If you are planning a pregnancy, check whether you need to be vaccinated against rubella.
  • When you have been vaccinated, avoid getting pregnant for a month after your last MMR vaccination.
  • For further information and support, talk to your doctor or practice nurse. To find out more about rubella vaccination, contact the Immunisation Advisory Centre (IMAC) 0800 466 863.

Who is at risk of getting rubella?

Rubella is uncommon in New Zealand, but cases still occur. Anyone who hasn’t been vaccinated against rubella is at risk, in particular, if you were born outside New Zealand where vaccination against rubella may not be widespread. The following groups of women are most likely to be non-immune to rubella:

  • women born overseas (especially in Asia, the Pacific Islands, sub-Saharan Africa and South America) who entered New Zealand after the age of routine vaccination
  • women over the age of 35 years.

How is rubella treated?

There are no specific treatments for rubella and symptoms usually go away after a few days. There are things you can do to ease your symptoms, such as:

  • using pain relief, such as paracetamol to reduce pain and discomfort
  • keeping yourself hydrated, and having adequate fluids to avoid dehydration.

How can I prevent the spread of rubella?

If you have rubella, to prevent others catching the disease from you, it is important to stay at home when you are ill. Avoid contact with anyone you know who may be in the early stages of pregnancy.

Why is vaccination so important?

Vaccination with the MMR vaccine is the best way to protect against rubella. In New Zealand, this is free for all children at ages 15 months and 4 years, or to anybody who is not vaccinated, or whose immunisation history is unknown. Even though rubella poses the most risk to pregnant women, boys should also be vaccinated. This is because the speed that rubella can spread in the community depends on the number of people who are not immunised. The infection will not spread if enough people are immunised. This is called herd-immunity.

Learn more 

Rubella Immunisation Advisory Centre (IMAC), 2017
Diseases we immunise against Royal New Zealand Plunket Society
Rubella DermNet NZ
Rubella NZ Ministry of Health

References

Rubella Immunisation Handbook, 2017

Credits: Health Navigator Editorial Team. Last reviewed: 11 Dec 2017