What is rubella?

Rubella (also known as ‘German measles’) is a viral infection which is usually mild. It’s not actually measles and is caused by the rubella virus. It is a very serious disease for pregnant women because it can cause severe harm to unborn babies if contracted during the first 10 weeks of pregnancy.

Thanks to vaccination, rubella is now rare in Australia, but it’s important to have your child vaccinated since outbreaks do still occur.

What are the symptoms of rubella?

Symptoms take 2 to 3 weeks to develop after infection with the rubella virus. Someone is infectious from 1 week before the rash first appears until at least 4 days after it has gone.

Some of the main symptoms of rubella include:

• a mild temperature
• conjunctivitis (a condition caused by inflammation of the eye)
• a distinctive red rash, with spots that may be itchy, and which usually lasts for up to 3 days. The rash usually starts behind the ears, before spreading across the head and neck; it may then spread to the abdomen and chest, legs and arms
• swollen lymph nodes (glands), especially at the back of the neck
• cold-like symptoms, such as a runny nose, watery eyes, sore throat and cough

What should I know about rubella and pregnancy?

Birth defects can develop if rubella infection occurs in early pregnancy — the earlier the infection, the greater the risk.

• If you are planning to become pregnant, you should get your rubella immunity checked. If you have no immunity, you can be vaccinated against rubella before getting pregnant. Your immunity should be checked again before each pregnancy.
• If you are already pregnant, but have not previously been immunised against rubella, you should be vaccinated after the baby is born. You cannot be vaccinated while you are pregnant.

Contact your doctor immediately:

• if you have had face-to-face contact with someone who has rubella
• if you spent more than 15 minutes in the same room as someone who has rubella
• you have some of the symptoms of rubella

The rubella virus can be passed to an unborn baby. It can cause a series of birth defects known as congenital rubella syndrome (CRS). CRS can include hearing and visual impairments, heart problems, brain damage, growth problems and swelling in the brain, liver and lungs.

Up to 9 out of 10 babies whose mother caught rubella during the first 10 weeks of pregnancy will have CRS, with multiple birth defects. After 20 weeks, the risk of CRS is minimal.

If testing shows that you have rubella, you may be referred to an obstetrician (a doctor who provides specialised medical care during pregnancy and birth).

When should I see a doctor about rubella?

You should always contact your doctor if you suspect that you or your child has rubella. Do not visit your doctor's surgery without calling them first because you will put anyone who is not immune at risk of catching the rubella infection.

What causes rubella?

Rubella is caused by the rubella virus, which is spread through personal contact or by coughing and sneezing. Once you have had rubella, you normally develop a lifelong immunity to further infection.

How is rubella diagnosed?

Your doctor may suspect that you have rubella based on your symptoms, but other viral infections often have similar symptoms so a blood test is the only way to confirm a diagnosis.

How is rubella treated?

Rubella is usually mild and there is no specific treatment for the condition.

Symptoms can be relieved by:

• getting plenty of rest
• drinking plenty of fluids
• taking paracetamol for pain or fever

Symptoms often disappear within 7 to 10 days, but it is still very important to avoid infecting someone else with the rubella virus.

• Adults should stay off work for at least 4 days from when the rash first appears or when fully recovered.
• Children should stay away from school for at least 4 days after the rash first appears or when fully recovered.
• Anyone with rubella should avoid contact with pregnant women for at least one week after the rash first appears.

Can rubella be prevented?

Rubella vaccine

Vaccination is your best protection against rubella. The vaccine is given in combination with the measles and mumps vaccine — known as the MMR vaccine. it is both safe and effective.

Children receive their first dose of MMR at 12 months, then a second dose at 18 months (called the MMRV, which includes the varicella — chicken pox — vaccine).

This table explains how the vaccine is given, who should get it and whether they qualify for free vaccination under the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.

What age is it recommended?	At 12 months and 18 months. Anyone older who has not had 2 doses of the vaccine previously.
How many doses are required?	2
How is it administered?	Injection
Is it free?	Free for children at 12 and 18 months. Free for people under 20 years old, refugees and other humanitarian entrants of any age. For everyone else, there is a cost for this vaccine. Find out more on the Department of Health website and the National Immunisation Program Schedule, and ask your doctor if you are eligible for additional free vaccines based on your situation or location.
Common side effects	The vaccine is very safe. Possible side effects include fever, rash and feeling unwell.

If your child has rubella, they should stay home from child-care or school. Here is a list of common childhood illnesses, including rubella, and their recommended exclusion periods.

If you have any concerns, you can discuss them with your doctor. Further information on immunisation can be found on the 'Immunisation for your child' article.

Resources and support

• If you need to know more about rubella, or need advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week.
• Find out more here about the National Immunisation Program Schedule.