Rubella (German Measles)
Rubella, commonly called German measles, is a vaccine-preventable rash illness caused by the rubella virus. It is usually a mild disease but can be severe in some cases. Rubella during pregnancy (congenital rubella) can cause severe complications, such as birth defects, miscarriage or fetal death.
Transmission
Rubella is spread person to person by droplets spread while sneezing or coughing. A person is infectious with rubella from one week before and until one week after onset of the rubella rash. A pregnant person may transmit rubella to their fetus
Symptoms
In children, rubella is usually mild, with few noticeable symptoms.
For children with symptoms,
- widespread red rash is typically the first sign.
- The rash generally first appears on the face and then spreads to the rest of the body, lasting about three days.
Other symptoms may appear before the rash include:
- cold-like symptoms
- fever
- pink eye
Most adults who contract rubella typically experience a mild illness, with
- low-grade fever
- sore throat
- rash that begins on the face and spreads to the rest of the body.
Many people with rubella will experience few to no symptoms.
Diagnosis
A health care provider can diagnose rubella. A laboratory test is needed to confirm the diagnosis. Because rubella disease is eliminated in the United States, a person likely would have traveled recently to another country or been exposed to someone who recently traveled. Diagnosis in the U.S. requires consultation with the North Dakota Department of Health and Human Services (NDHHS) and the Centers for Disease Control and Prevention (CDC).
Treatment
There is no treatment for rubella. Health care providers will recommend supportive care if necessary.
Prevention
All children between 12 and 15 months of age should be vaccinated with the first dose of MMR (measles, mumps and rubella vaccine). A booster dose of MMR is recommended at 4 to 6 years of age. Two doses of mumps-containing vaccine are about 88 percent effective in preventing illness. Children are required to submit documentation of age-appropriate immunization against mumps to attend early child care facilities, schools, and colleges in North Dakota.
- The immunization status of all children and staff at schools or early childhood facilities should be reviewed.
- During mumps outbreaks, exposed children and staff who have not been immunized should be excluded until they are vaccinated, or, if they refuse vaccination, they should be quarantined for an appropriate amount of time following exposure.
- During rubella outbreaks, the NDHHS may recommend that certain individuals receive a third dose of MMR vaccine.
Exclusion Guidance
People with rubella must be excluded from work, school, or child care until no longer infectious. Rubella is a highly contagious disease and poses a serious risk to pregnant people. Outbreak situations may also require the exclusion of unvaccinated persons.
For additional information about rubella,
contact the North Dakota Department of Health and Human Servicesโ, Division of Public Health, at 800.472.2180.
Resources
1.Centers for Disease Control and Prevention. (2020, December 31). CDC Rubella (German measles). Centers for Disease Control and Prevention. Retrieved June 28, 2023, https://www.cdc.gov/rubella/about/transmission.html.
2. Kimberlin, D. W., Barnett, E. D., Lynfield, R., Sawyer, M. H. (2021) Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32 nd ed. American Academy of Pediatrics. [Management and Prevention of Infectious Diseases; Rubella] [pages 648- 655].