Your Guide to Rubella: Everything You Need to Know

Medically Reviewed By Michaela Murphy, PA-C
Was this helpful?
1

Rubella, also known as German measles, is a condition caused by the rubella virus. The main symptoms of rubella include a rash, fever, and swollen glands. Rubella is now rare in the United States. Rubella is generally mild and not harmful. However, if you have rubella when you are pregnant, it can harm the fetus.

This guide explains the symptoms of rubella and how to treat them. It also includes information about causes, diagnosis, the rubella vaccine, and what to know if you are pregnant or thinking of starting a family.

Key facts about rubella

  • The main symptoms of rubella include a rash, swollen glands, and fever.
  • Symptoms are usually mild but can be harmful to a fetus if you have rubella during pregnancy.
  • Children typically get the MMR vaccine in two doses by the time they are 6 years old.
  • Most people experience symptoms around 16–18 days after exposure to the virus.
  • Other names include German measles and 3-day measles.

What does a rubella rash look like?

Key characteristics of rubella include a rash, swollen glands, and a low grade fever. View the slideshow below for pictures of rubella.

rubella-or-german-measles-body2.jpg

The rash of rubella, also known as German measles, closely resembles the measles rash, but it is not as widespread.

Photography courtesy of CDC/Wikimedia

Skin,Of,Rubella,Patient,,Rubella,Infection,People,,Skin,Clinical,Sign,

Rubella is a viral illness that causes a rash on the face that spreads to the rest of the body.

Akkalak Aiempradit/Shutterstock

What are the symptoms of rubella?

A little girl is lying down.
Maria Manco/Stocksy United

Around 25–50% of people with rubella do not experience any symptoms. When symptoms do occur, they are typically mild.

You may begin to experience symptoms of rubella around 12–23 days after exposure to the virus. For most people, symptoms appear within 16–18 days.

The first sign of rubella is usually a rash that appears on the face. The rash can spread to the rest of the body, except for the palms and the soles. It will last around 3 days.

Some people also experience symptoms 1–5 days before the rash appears. These can include:

  • headache
  • low grade fever
  • general discomfort
  • mild pink eye, or redness of the whites of the eyes
  • cough
  • runny nose
  • swollen, enlarged lymph node

How is rubella treated?

There is no specific treatment that alleviates symptoms of rubella. As the virus runs its course, you can take the following steps to ease pain and discomfort:

  • Get as much rest as possible.
  • Make sure you drink plenty of fluids.
  • Take medication for pain relief.

Contact your pharmacist for information about over-the-counter medications that can help relieve rubella symptoms such as headache, fever, and joint pain.

Is the MMR vaccine for rubella?

The MMR vaccine received FDA licensing to use in the U.S. in 1971. It protects against:

Children typically receive two doses of the MMR vaccine: one around ages 12–15 months, and a second dose at around 4–6 years.

One dose of the MMR vaccine is around 97% effective at protecting against rubella.

Some children may receive the MMRV vaccine. It protects against measles, mumps, rubella, and chickenpox.

Learn more about the childhood vaccination schedule.

Can adults get the MMR vaccine?

If you did not get the MMR or MMRV vaccine as a child, contact your doctor about getting vaccinated.

Rubella is now rare in countries with a rubella vaccine program. However, you can still carry the virus if you travel to countries where it is more common. Having the vaccine helps to protect you and other people from rubella.

Most health insurance plans cover vaccines.

How do doctors diagnose rubella?

Your doctor may diagnose rubella in a child from the appearance of the rash alone. They will examine the rash while considering the child’s medical history.

However, it may be necessary to diagnose rubella in adults with laboratory tests, particularly for people who are pregnant or of childbearing age. These tests include immunoglobulin G (IgG) and immunoglobulin M (IgM) serology.

IgG and IgM are two rubella antibodies. If they are present in a blood test, they can indicate recent or previous exposure to the virus.

Your doctor may also take a throat swab or urine sample to test for rubella.

What causes rubella?

Rubella occurs as a result of the virus Rubivirus genus. You can get rubella if you come into contact with somebody who has the virus.

Is rubella contagious?

Rubella is a contagious virus that transmits through airborne droplets. This means that you can get rubella if somebody with the virus sneezes or coughs near you.

Is rubella harmful during pregnancy? 

Rubella can be incredibly harmful to the fetus if you contract the virus during pregnancy. If you have rubella during the first trimester, there is a 50% chance that the fetus will be affected somehow. Potential effects of rubella exposure during pregnancy can include:

Congenital rubella syndrome

Congenital rubella syndrome is most common if you have rubella at any point from just before conception to the first 8–10 weeks of pregnancy. Fetal abnormalities occur in around 90% of rubella cases during this period. This risk decreases after 18–20 weeks but does not go away.

Common symptoms and features of congenital rubella syndrome include:

Prior to the introduction of the rubella vaccine, congenital rubella syndrome occurred in around 0.8–4 per 1,000 live births.

How common is rubella?

Rubella is no longer a common condition in countries with a rubella vaccine program. The U.S. eliminated rubella in 2004, and the United Kingdom did in 2015.

There are typically fewer than 10 reported rubella cases in the U.S. each year. Most people with the virus are exposed to it when living or traveling outside of the U.S.

Learn more about other conditions eliminated and reduced as a result of vaccines.

Can I prevent rubella?

The MMR vaccine can prevent rubella. Children typically receive two doses of the vaccine: one between the ages of 12–15 months, and one when they are around 4–6 years old.

If you are thinking about having a baby, contact your doctor to make sure that you have had the vaccine. Blood tests will determine if you have rubella antibodies.

Can rubella cause complications?

It is rare to experience most complications of rubella if you are healthy when you contract the virus. However, complications can include:

Around 70% of females (assigned at birth) who get rubella will experience arthritis. This complication is rare in males and children.

Find out more about arthritis.

When should I contact a doctor?

Contact your doctor if you experience symptoms of rubella, particularly if you have recently lived in or traveled to a country that does not have a rubella vaccine program.

You should also contact your doctor if you do not know if you have had the rubella vaccine before. They will be able to arrange for a blood test to determine whether or not you have rubella antibodies.

Make sure you have had the rubella vaccine if you plan to start a family or travel to a country with no vaccine program.

Summary

Rubella is a viral illness with symptoms that include a rash, fever, and swollen lymph nodes. Since the introduction of the MMR vaccine in 1971, the U.S. has had fewer than 10 cases per year.

The MMR vaccine protects you against rubella. Children typically receive it in two doses by the time they are 6 years old. However, you can also get the vaccine as an adult if you have not had it before.

Rubella can harm a fetus. Therefore, it is particularly important to make sure you are protected against rubella if you are thinking of starting a family. Rubella during the first trimester of pregnancy can result in miscarriage, stillbirth, or congenital rubella syndrome.

Contact your doctor if you have symptoms of rubella or if you want to make sure that you have previously had the vaccine.

Was this helpful?
1
Medical Reviewer: Michaela Murphy, PA-C
Last Review Date: 2022 May 3
View All Infections and Contagious Diseases Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Congenital rubella syndrome: Vaccine preventable diseases surveillance standards. (2018). https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-crs
  2. Immunization, vaccines and biologicals. (n.d.). https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/rubella
  3. Lanzieri, T., et al. (2021). Chapter 20: Rubella. Epidemiology and Prevention of Vaccine-Preventable Diseases. Washington, D.C. Public Health Foundation. https://www.cdc.gov/vaccines/pubs/pinkbook/rubella.html
  4. Measles, mumps, rubella antibody. (n.d.). https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=mmr_antibody
  5. MMRV (measles, mumps, rubella & varicella) VIS. (2021). https://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmrv.html
  6. Oakley, A. (2016). Rubella. https://dermnetnz.org/topics/rubella
  7. Rubella (German measles). (2022). https://vk.ovg.ox.ac.uk/vk/rubella
  8. Rubella. (2020). https://www.cdc.gov/rubella/index.html