How to Recognize and Prevent Rubella (German Measles)

Two Parts:Recognizing the Symptoms of RubellaPreventing Rubella

Rubella, also know as German measles or 3-day measles, is a contagious childhood infection caused by the rubella virus.[1] Rubella is named so because it causes a distinctive red rash. Rubella is different and milder than regular measles (also called rubeola), although the two illnesses share some similar symptoms. Due to widespread vaccination against rubella (via the MMR vaccine) the Centers for Disease Control and Prevention has claimed the infection is eliminated in the U.S., although it still infects people in some other countries.

Part 1
Recognizing the Symptoms of Rubella

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    Look for a pinkish skin rash. The signs and symptoms of a rubella infection tend to be very mild and difficult to notice. However, its most distinctive characteristic is a fine, pink-colored rash that begins on the face and quickly spreads to the neck, trunk and then the limbs.[2] The rash typically lasts for between 1-3 days, then disappears in the same sequence that it appeared (face -> trunk -> limbs).
    • The distinctive skin rash only occurs in 50–80% of cases of rubella.[3]
    • If the rash and other symptoms appear, they do so between 2-3 weeks after exposure to the virus.
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    Watch for a mild fever. Another common feature of rubella (and virtually all infections) is a fever. However, unlike some other viral infections, rubella only triggers a mild fever of 102°F (38.9°C) or lower in children and young adults.[4] The fever only lasts for about 3 days and should not be treated with medicine because increased body temperature stimulates the immune system and slows down the ability for viruses to produce and spread.
    • As with any fever, it's smart to keep well hydrated. Children with mild fevers should have a small glass of water or diluted juice every few hours while they're awake.
    • Mild fevers sometimes reduce appetite or lead to some nausea, although vomiting is not a typical sign of rubella.
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    Check for inflamed lymph nodes. Another sign that the body is fighting an infection, especially an upper respiratory one like rubella, is inflamed or enlarged lymph nodes (glands).[5] Blood and lymph fluid is filtered by lymph nodes, which contain specialized white blood cells that kill viruses and other pathogens. In doing so, they often get enlarged, inflamed and tender. Check behind your ears, along the sides and back of your neck and above your collarbones for tender lymph nodules.
    • With mild acute (short-term) infections, lymph glands only get enlarged and tender for a few days.
    • Don't confuse inflamed lymph glands with pimples, boils or ingrown hairs.
    • Older children and adults are much more likely than young children to develop swollen glands before the pink rash appears.[6]
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    Don't be fooled by typical cold symptoms. Other symptoms of rubella tend to mirror those of the common cold, except they tend to be more mild. These common upper respiratory symptoms include stuffy or runny nose, sneezing, inflamed bloodshot eyes, fatigue and headaches.[7] Unlike the common cold and influenza infections, rubella doesn't lead to a sore throat, excessive coughing or lung congestion.
    • Infected adults, particularly women, sometimes develop achy joints and symptoms similar to arthritis that can last between 3–10 days.[8]
    • Rubella spreads in the same way that the common cold and influenza do — via tiny droplets when infected people sneeze, cough or leave secretions on surfaces.
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    Be aware of complications during pregnancy. When women are infected with the rubella virus early during their pregnancy (first trimester), they have a 90% chance of passing the virus on to their developing fetus.[9] When this happens, there is a 20% chance of miscarriage, stillbirth or severe birth defects, such as deafness, cataracts, heart defects, mental retardation, and liver / spleen damage.[10]
    • Rubella infection during pregnancy is the most common cause of deafness in newborns.
    • If you want to get pregnant, make sure you've received your MMR vaccination well in advance.
    • If you're already pregnant, your doctor will likely screen you for immunity to rubella by taking a blood test.

Part 2
Preventing Rubella

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    Get the measles-mumps-rubella (MMR) vaccine. The rubella vaccine is usually given as a combined measles-mumps-rubella inoculation during early childhood — doctors recommend shots between 12-15 months old, then again between 4-6 years old (before entering school).[11] Usually newborns are protected from rubella for up to 8 months due to the natural immunity passed on from their mothers.
    • Almost everyone who receives the MMR vaccine has immunity to rubella because the body builds antibodies against the rubella virus.
    • It's especially important that young girls receive the MMR vaccine to prevent rubella during future pregnancies due to the potential complications.
    • In some adults, the vaccine may "wear off" or not be effective. In such cases, it's possible to get a booster shot from your family doctor.
    • Rubella vaccines are also available by themselves (monovalent formulation), combined with only the measles vaccine (MR), or along with the measles, mumps and varicella vaccines (MMRV).[12]
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    Be cautious when traveling abroad. The United States, Canada and some countries in Europe have the highest rates and numbers of vaccinations in the world. Traveling to other countries, particularly underdeveloped ones in Africa and Asia, can put you at risk of getting infected by rubella or other viruses.[13] One extreme solution is not to travel abroad to these countries, but a more reasonable approach is to take precautions while there. Washing your hands frequently and avoiding exchanging saliva or other body fluids with strangers is usually enough to prevent most infections.
    • Some developed countries in Europe and Asia, such as Japan, no longer give children MMR vaccines due to potential side effects. As such, you might be at higher risk of infection while in those countries.
    • Consider a booster shot of just the rubella vaccine if traveling to foreign countries — but sometimes (in rare cases) the side effect symptoms are worse than the actual infection.
    • Contact the World Health Organization (WHO) or look on their website to find out which countries vaccinate their population against the rubella virus.
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    Keep your immune system strong. For any type of infection, true prevention depends on a strong immune system.[14] Your immune system consists of specialized white blood cells that search and destroy disease-causing microorganisms such as the rubella virus. However, when it's weakened and malfunctioning, viruses and other pathogens can grow unchecked in body fluids and mucus, leading to various symptoms. Therefore, focus on ways to keep your immune system healthy in order to naturally prevent rubella and other infections.
    • Getting more sleep (or better quality sleep), eating lots of fresh fruit and veggies, practicing good hygiene, keeping well hydrated and getting regular exercise are all ways to boost your immune system.[15]
    • Pay attention to your diet. Your immune system also benefits by cutting down on refined sugars (sodas, candy, ice cream, chocolate), cutting back on alcohol consumption and quitting smoking.
    • Supplements that can strengthen your immune response include: vitamins A, C and D, zinc, selenium, echinacea, olive leaf extract and astragalus root.[16]


  • People who are ill, either moderately or severely, should wait until they are well before receiving the MMR vaccine.
  • Children who are known to have a severe allergy to gelatin or the antibiotic neomycin should not get an MMR vaccination.
  • Although rubella is rare in the United States, it continues to exist in many parts of the world. Travelers should take the necessary precautions when traveling to areas where the disease is known to be widespread.


  • Expectant women should wait to get the vaccine until after they have given birth. Women should not get pregnant for up to 4 weeks after receiving the vaccine.
  • Pregnant women and children who have not had the MMR or MMRV vaccine should avoid traveling to countries where rubella is endemic.
  • Check with your health care provider before getting the vaccine if you have a disease that affects the immune system, have cancer, or suffer from a blood disorder.

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Categories: Infectious Diseases