German measles, also known as rubella, is a viral infection that causes a red rash on the body.

Aside from the rash,

people with German measles usually have a fever and swollen lymph nodes. The infection can spread from person to
person through contact with droplets from an infected person's sneeze or cough.

What is German measles?

German measles, also known as rubella, is a viral infection that causes a red rash on the body. Aside from the rash,
people with German measles usually have a fever and swollen lymph nodes. The infection can spread from person to
person through contact with droplets from an infected person’s sneeze or cough. This means that you can get German
measles if you touch your mouth, nose, or eyes after touching something that has droplets from an infected person on
it. You may also get German measles by sharing food or drinks with someone who’s infected.
German measles is rare in the United States. With the introduction of the rubella vaccine in the late 1960s, the incidence
of German measles significantly declined. However, the condition is still common in many other parts of the world. It
mainly affects children, more commonly those between 5 and 9 years old, but it can also occur in adults.
German measles is typically a mild infection that goes away within one week, even without treatment. However, it can
be a serious condition in pregnant women, as it may cause congenital rubella syndrome in the fetus. Congenital rubella
syndrome can disrupt the development of the baby and cause serious birth defects, such as heart abnormalities,
deafness, and brain damage. It’s important to get treatment right away if you’re pregnant and suspect you have German
measles.
What are the symptoms of German measles?
The symptoms of German measles are often so mild that they're difficult to notice. When symptoms do occur, they
usually develop within two to three weeks after the initial exposure to the virus. They often last about three to seven
days and may include:
 pink or red rash that begins on the face and then spreads downward to the rest of the body
 mild fever, usually under 102°F
 swollen and tender lymph nodes
 runny or stuffy nose
 headache
 muscle pain
 inflamed or red eyes
Although these symptoms may not seem serious, you should contact your doctor if you suspect you have German
measles. This is especially important if you’re pregnant or believe you may be pregnant.
In rare cases, German measles can lead to ear infections and brain swelling. Call your doctor immediately if you notice
any of the following symptoms during or after a German measles infection:
 prolonged headache
 earache
 stiff neck
What causes German measles?
German measles is caused by the rubella virus. This is a highly contagious virus that can spread through close contact or
through the air. It may pass from person to person through contact with tiny drops of fluid from the nose and throat
when sneezing and coughing. This means that you can get the virus by inhaling the droplets of an infected person or
touching an object contaminated with the droplets. German measles can also be transmitted from a pregnant woman to
her developing baby through the bloodstream.
People who have German measles are most contagious from the week before the rash appears until about two weeks
after the rash goes away. They can spread the virus before they even know that they have it.
Who is at risk for German measles?
German measles is extremely rare in the United States, thanks to vaccines that typically provide lifelong immunity to the
rubella virus. Most cases of German measles occur in people who live in countries that don't offer routine immunization
against rubella.
The rubella vaccine is usually given to children when they’re between 12 and 15 months old, and then again when
they’re between ages 4 and 6. This means that infants and young toddlers who haven’t yet received all vaccines have a
greater risk of getting German measles.
To avoid complications during pregnancy, many women who become pregnant are given a blood test to confirm
immunity to rubella. It’s important to contact your doctor immediately if you've never received the vaccine and think
you might have been exposed to rubella.
How does German measles affect pregnant women?
When a woman contracts German measles during pregnancy, the virus can be passed on to her developing baby through
her bloodstream. This is called congenital rubella syndrome. Congenital rubella syndrome is a serious health concern, as
it can cause miscarriages and stillbirths. It can also cause birth defects in babies who are carried to term, including:
 delayed growth
 intellectual disabilities
 heart defects
 deafness
 poorly functioning organs
 Women of childbearing age should have their immunity to rubella tested before becoming pregnant. If a vaccine is
needed, it’s important to get it at least 28 days before trying to conceive.
How is German measles diagnosed?
Since German measles appears similar to other viruses that cause rashes, your doctor will confirm your diagnosis with a
blood test. This can check for the presence of different types of rubella antibodies in your blood. Antibodies are proteins
that recognize and destroy harmful substances, such as viruses and bacteria. The test results can indicate whether you
currently have the virus or are immune to it.
TREATMENT
How is German measles treated?
Most cases of German measles are treated at home. Your doctor may tell you to rest in bed and to
take acetaminophen (Tylenol), which can help relieve discomfort from fever and aches. They may also recommend that
you stay home from work or school to prevent spreading the virus to others.
Pregnant women may be treated with antibodies called hyperimmune globulin that can fight off the virus. This can help
reduce your symptoms. However, there’s still a chance that your baby will develop congenital rubella syndrome. Babies
who are born with congenital rubella will require treatment from a team of specialists. Talk to your doctor if you’re
concerned about passing German measles on to your baby.
How can I prevent German measles?
For most people, vaccination is a safe and effective way to prevent German measles. The rubella vaccine is typically
combined with vaccines for the measles and mumps as well as varicella, the virus that causes chicken pox.
These vaccines are usually given to children who are between 12 and 15 months old. A booster shot will be needed
again when children are between ages 4 and 6. Since the vaccines contain small doses of the virus, mild fevers and
rashes may occur.
If you don’t know whether you’ve been vaccinated for German measles, it’s important to have your immunity tested,
especially if you:
 are a woman of childbearing age and aren’t pregnant
 attend an educational facility
 work in a medical facility or school
 plan to travel to a country that doesn’t offer immunization against rubella
While the rubella vaccine usually isn’t harmful, the virus in the shot could cause adverse reactions in some people. You
shouldn’t be vaccinated if you have a weak immune system due to another illness, are pregnant, or plan to become
pregnant within the next month.
Rubella is an infection caused by the rubella virus; it can cause severe harm to the unborn child. The number of
rubella cases has fallen dramatically, thanks to vaccination programs, but the battle against this infection is not yet
won.
The symptoms of rubella (also known as German measles) are often so mild that more than half of people with the
infection do not even notice that they have contracted it. 1
However, rubella contracted during early pregnancy can cause substantial negative outcomes for the unborn child. This
is known as congenital rubella syndrome.
Rubella is a preventable disease; the vaccine is often given in conjunction with measles and mumps (MMR vaccine).
Before the vaccine was widely available, the US would see widespread outbreaks every 6-9 years. In Europe, outbreaks
would occur every 3-5 years.
Although the World Health Organization (WHO) declared the Americas officially free of rubella transmission on 29 April
2015, the current rate of vaccination is only around 80%. Because the disease can arrive with overseas travelers, it is
essential to maintain a high rate of immunization.
In this article, we will discuss the symptoms, diagnosis and treatment of rubella.
Contents of this article:
 Rubella, its symptoms and congenital rubella syndrome
 Diagnosis, treatment and prevention of rubella
Fast facts on rubella
Here are some key points about rubella. More detail and supporting information is in the main article.
 "Rubella" is Latin for "little red"
 Rubella is viral and predominantly transmitted by coughs
 The rubella virus can pass across the placenta and affect the fetus
 Roughly half of rubella cases present very few symptoms
 The predominant symptom of rubella is a rash, but other symptoms include a runny nose, headache and fever
 Rubella in pregnant women can cause congenital rubella syndrome in the unborn child
 Congenital rubella syndrome is the leading cause of congenital deafness
 Diagnosis can be made by testing blood or saliva samples
 There are no medications that shorten the rubella infection
 The rubella vaccination is the only way to prevent the disease.
 What is rubella?

Characterized by a red rash, "rubella" is Latin for "little red." The rash from which it gets its name is generally less bright
than measles but can be itchy.
Rubella was first described as a separate disease from measles by scientists in Germany, hence its alternative name -
German measles.
The virus replicates in the lymph nodes and the nasopharynx (the tube connecting the nasal cavity and the soft palate)
and is transmitted via coughs. An individual with rubella is contagious for 1 week before the rash arrives and for 1 week
after.
Between 5 and 7 days after infection, the virus can be found in the blood as it spreads throughout the body. The rubella
virus is capable of passing through the placenta and has teratogenic (mutation-causing) properties. The virus can destroy
cells, or prevent them from dividing - this causes congenital rubella syndrome.
Rubella rarely strikes in young infants or people over 40. In general, the older the individual, the worse the symptoms of
rubella will be.
Symptoms of rubella
Around half of rubella cases pass unnoticed. For infections that are serious enough to take hold, the major symptom is a
pinkish-red rash that appears 2-3 weeks after exposure to the virus. 2
The rash often starts on the face and moves to the trunk and limbs. After 3 days of the rash, it fades and disappears,
hence one of its alternative names - 3-day measles.
Other symptoms of rubella include:
 Stuffy or runny nose
 Headache
 Mild fever (102 °F or lower)
 Inflamed, red eyes
 Testicular swelling
 Inflammation of nerves
 Lymph nodes enlarged and tender
 Joint aches.
Congenital rubella syndrome
Congenital rubella syndrome occurs when a pregnant woman contracts the rubella virus and it passes through the
placenta to the unborn child. The infection can trigger miscarriage or stillbirth, or cause severe damage to the
developing fetus. Congenital rubella syndrome is the leading cause of congenital deafness.
If infected during the first trimester, there is a 51% chance that the fetus will be affected. This likelihood drops to 23% if
infected 13-26 weeks after conception. Worldwide, there are an estimated 100,000 cases of congenital rubella
syndrome every year.3
Often, more than one defect can arise, with deafness being the most common. These effects on the infant can include: 4

 Deafness or hearing impairment

 Cataracts
 Congenital heart disease (especially pulmonary artery stenosis and patent ductus arteriosus)
 Anemia
 Hepatitis
 Developmental delay
 Retinopathy (acute damage to the retina)
 Microphthalmia (abnormally small, deformed eyes)
 Liver, spleen or bone marrow issues (sometimes disappearing shortly after birth)
 Small head
 Low birth weight
 Micrognathism (small lower jaw).
As the child develops, there might be conditions that appear as they age. These might
include autism,5schizophrenia,6 learning disabilities and diabetes.7 However, if rubella is contracted after the 20th week
of pregnancy, problems in the newborn are rare.
Although currently under control in the US, rubella can mete out a deadly toll if an outbreak occurs. According to the
Centers for Disease Control and Prevention (CDC):
"During the 1962-1965 global rubella pandemic, an estimated 12.5 million rubella cases occurred in the United States,
resulting in 2,000 cases of encephalitis, 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000
infants born with congenital rubella syndrome."
The precise mechanisms by which the rubella virus influences the fetus are unknown. Some research shows that it might
involve apoptosis, otherwise known as programmed cell death.
Apoptosis is a normal physiological process that is triggered for a variety of reasons. For instance, the separation of a
fetus' fingers and toes is reliant on the apoptosis of the cells between each digit.
It appears that under the influence of rubella, this mechanism becomes out of control. Some studies implicate a tumor-
suppressor protein called p53. Research into the molecular actions involved is ongoing.
 Diagnosis of rubella
If an individual believes they have rubella, it is important to call the doctor's office rather than visiting. It is vital to avoid
interaction with pregnant women.8
Diagnosis is made by testing a saliva or blood sample. If IgM antibodies are present, they signify a new rubella infection.
If IgG antibodies are present, they indicate that a rubella infection has either been present in the past or the individual
has already been vaccinated.
If neither antibody is present, the individual does not carry a rubella infection and has never been immunized.
Treatment of rubella
There are no medications that shorten the rubella infection. Most often, the symptoms are mild enough that no
treatment is necessary. Doctors recommend that someone with a rubella infection isolates themselves during the
infectious period - 1 week before the rash appears (if the individual thinks they have been infected) and 1 week after the
rash appears.
If pregnant, hyperimmune globulin may be prescribed to help fight off the virus and reduce the chance of congenital
rubella syndrome.9
Prevention of rubella
The only effective way to prevent the contraction of rubella is through vaccination. Taken in conjunction with measles
and mumps, the MMR vaccine prevents transmission and has been in use for 40 years.
The vaccine comes in the form of a live attenuated (weakened) virus and is delivered at 12-15 months with a second
dose at 4-6 years old.
The following adults should get the MMR vaccine:
 Students
 Those working in health care
 Women of childbearing age
 International travelers.
The following adults do not need the MMR vaccine:
 Anyone with blood tests showing they are immune to measles, mumps and rubella
 People born before 1957 who are not planning on getting pregnant
 Anyone who has already had two doses of MMR or one dose of MMR plus a second dose of measles vaccine
 Anyone who has already had one dose of MMR and are not at high risk of measles or mumps exposure.
Pregnant women or people thinking of getting pregnant in the next 4 weeks should not get the shot. Also, anyone who is
sick should wait until they are better before having the vaccination.
Side effects of the vaccine are minimal. Roughly 15% of people will have a mild fever around 7-12 days after the injection
and 5% will develop a minor rash. Teenage or adult women may experience joint aches. Fewer than 1 in 1,000,000 have
a severe reaction.