Rubella

Rubella, also known as German measles, is an infectious disease caused by the rubella virus. Rubella is not very common in Australia due to high levels of immunisation.

Symptoms

Symptoms of rubella may include:

• mild fever
• rash
• runny nose
• conjunctivitis
• swollen lymph glands
• sore joints.

In rare cases, rubella infection can be complicated by lowering of the platelet count (thrombocytopenia) which can cause bleeding, or by encephalitis (inflammation of the brain).

Rubella infection in a woman during early pregnancy may cause miscarriage and severe birth defects in the infant, including heart defects, deafness, brain damage, and eye problems (including cataracts). The risk is highest during the first 10 weeks of pregnancy and rare after 20 weeks of pregnancy.

How Rubella is spread

Rubella is spread through contact with respiratory droplets or direct contact with an infected person.

It is important that a person infected with rubella avoid contact with others to reduce the risk of spreading the disease. They should be excluded from school, childcare or work until they are no longer infectious.

Infectious period

A person with rubella can be infectious in the 7 days before and for 4 days after the rash begins.

Who is at risk of infection

Anyone who comes into contact with the virus can get rubella, unless they have immunity from past infection or from vaccination.

Although the infection is mild for most people, rubella infection early in pregnancy can cause serious birth defects and miscarriage. Women planning a pregnancy should have a blood test to check their immunity against rubella before falling pregnant.

If you have contact with someone with rubella

Symptoms usually develop between 14 to 21 days after coming into contact with the rubella virus. Anyone with suspected rubella should see their doctor. Pregnant women who have come into contact with rubella should see their doctor for advice.

Diagnosis

It is difficult to diagnose rubella based on the person’s symptoms alone. If your doctor suspects you may have rubella, a blood test, swab from the throat, or a urine specimen can confirm the diagnosis.

Treatment

There is no specific treatment for rubella. People with rubella should see their doctor for advice on how to manage their symptoms. They should also drink plenty of fluids and rest.

Immunisation

Vaccination is the best way to prevent being infected with rubella. A measles, mumps, rubella (MMR) vaccine is funded under the National Immunisation Program. This vaccine is offered to all children at 12 months of age and then again in combination with the chickenpox vaccine (MMRV) at 18 months of age. To be fully vaccinated, people need to receive two doses of a mumps containing vaccine at least four weeks apart.

Find out more about the MMR vaccine.

Vaccination status and immunity

If you were born prior to 1966 in Australia, it is likely that you had a natural rubella infection in your childhood and are now immune. If you were born during or after 1966, and have not had rubella infection, you should have received two doses of a rubella containing vaccine at least four weeks apart to be considered immune. If you are unsure whether you are immune, speak with your doctor about getting vaccinated. It is safe to have the vaccine more than twice.

Women planning a pregnancy should have a blood test to check their immunity against rubella before falling pregnant. If not immune, at least one dose of a MMR vaccine is recommended.

Although two doses of MMR vaccine are routinely recommended, women who show immunity after one dose do not need another dose. Women should avoid pregnancy for 28 days after vaccination.

Vaccination side effects

Side effects from the MMR and MMRV vaccines are usually mild and temporary. They may include fever, tiredness, faint red rash (not infectious), localised swelling at the injection site, swollen glands and feeling unwell.

These vaccines are not recommended for people who are immune-suppressed or for pregnant women. Pregnancy should be avoided for 28 days following vaccination. MMR or MMRV vaccination may also need to be delayed if you have had a recent blood transfusion or blood product.

More information

Rubella is a notifiable disease. For more information about rubella, contact your GP or call the Health Protection Service, Communicable Disease Control Information Line during business hours on 02 5124 9213.

Acknowledgements

• Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.
• Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018.