Rubella (German Measles)

Overview

Rubella, also known as German measles or three-day measles, is a contagious viral infection caused by the rubella virus. While rubella is generally mild in children and adults, it poses a serious threat to pregnant women and their developing babies.

The rubella vaccine has been available since 1969. The MMR vaccine provides about 97% protection against rubella after two doses. The primary goal of rubella vaccination is to prevent Congenital Rubella Syndrome (CRS), which can cause severe birth defects.

Rubella was a common childhood disease before the vaccine. Since vaccination programs began, rubella and CRS have been eliminated from many developed countries. WHO has set a goal to eliminate rubella in at least five WHO regions by 2025.

100,000+

CRS cases estimated annually

97%

Rubella vaccine effectiveness

90%

CRS risk in first trimester

Symptoms of Rubella

Symptoms typically appear 14-21 days after exposure to the virus. Up to 50% of rubella infections are subclinical (no symptoms).

Early Symptoms

Low-grade fever (below 101°F/38.3°C), headache, runny nose, red eyes, and general malaise

Lymphadenopathy

Swollen, tender lymph nodes behind the ears and at the back of the neck (characteristic sign)

Rubella Rash

Pink or light red rash that starts on the face and spreads to the trunk, arms, and legs. Fades in 2-3 days

Joint Pain

Arthritis or arthralgia (joint pain) common in adult women, affecting fingers, wrists, and knees

Contagious Period

From 1 week before to 1 week after rash appears. Most contagious when rash is developing

Duration

Illness typically lasts 2-3 days, which is why it's called 'three-day measles'

Prevention & Vaccination

MMR Vaccine

Primary Prevention

Two doses: First at 12-15 months, second at 4-6 years

97% effective against rubella

Preconception Vaccination

For Women

Women should be vaccinated at least 1 month before becoming pregnant

No pregnancy for 4 weeks after vaccination

CRS Elimination

Global Goal

WHO aims to eliminate rubella and CRS in 5 regions by 2025

Through high vaccination coverage

Rubella Screening

Prenatal Care

Pregnant women tested for rubella immunity early in pregnancy

Non-immune women vaccinated after delivery

Complications of Rubella

The most serious complication of rubella is Congenital Rubella Syndrome (CRS) in babies born to infected mothers, especially during the first trimester of pregnancy.

Congenital Rubella Syndrome

Devastating condition causing multiple birth defects including deafness, cataracts, heart defects, and intellectual disabilities

CRS - Hearing Loss

Sensorineural hearing loss affects up to 80% of CRS cases. Can be unilateral or bilateral.

CRS - Eye Defects

Cataracts (cloudy lens), glaucoma, retinopathy, and microphthalmia (abnormally small eyes)

CRS - Heart Defects

Pulmonary artery stenosis, patent ductus arteriosus, and other congenital heart abnormalities

Arthritis

Joint pain and swelling occurs in up to 70% of adult women with rubella. Usually resolves but can be chronic

Thrombocytopenia

Low platelet count causing bleeding tendency. Usually resolves but may require treatment

WHO Global Impact Data:

Rubella causes approximately 100,000 cases of Congenital Rubella Syndrome annually worldwide. Since rubella vaccine introduction, rubella and CRS have been eliminated from the Americas and many other regions. WHO has set a goal to eliminate rubella in at least five WHO regions by 2025 through high vaccination coverage.

Information Source:

All information based on World Health Organization (WHO) data, guidelines, and publications including:

• WHO Rubella Fact Sheets
• Weekly Epidemiological Record (WER) publications
• Global Measles and Rubella Strategic Plan 2012-2020

For latest updates, visit: WHO Rubella Information