What is rubella?

Rubella (German measles) is an infection caused by the rubella virus. It is usually a mild illness causing a rash, sore throat and swollen glands. It occurs most commonly in young children, but can affect anyone. Rubella is now uncommon in the UK as a result of the rubella immunisation. See separate leaflet called Rubella (German Measles) for more details.

What is the congenital rubella syndrome?

If you are pregnant and have rubella in the first few months of pregnancy, there is a high chance that the virus will cause severe damage to your developing baby. The virus affects the developing organs and the baby may be born with serious disability - the congenital rubella syndrome. Complications of congenital rubella syndrome include cataracts, deafness, and heart, lung and brain abnormalities. Having rubella infection in the first three months of pregnancy also increases your risk of having a miscarriage. The risks of your baby developing congenital rubella syndrome are greatest in the first 16 weeks of your pregnancy. The risk is highest in the first 12 weeks of pregnancy. The risk is much lower if you are more than 20 weeks pregnant.

Rubella Symptoms
After an incubation period of 1421 days, the primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days. Other symptoms include low grade fever, swollen glands (post cervical lymphadenopathy), joint pains, headache and conjunctivitis. The swollen glands or lymph nodes can persist for up to a week and the fever rarely rises above 38 oC (100.4 oF). The rash disappears after a few days with no staining or peeling of the skin. Forchheimer's sign occurs in 20% of cases, and is characterized by small, red papules on the area of the soft palate.

Rubella Diagnosis
Rubella virus specific IgM antibodies are present in people recently infected by Rubella virus but these antibodies can persist for over a year and a positive test result needs to be interpreted with caution. The presence of these antibodies along with, or a short time after, the characteristic rash confirms the diagnosis.

Prevention
Rubella infections are prevented by active immunisation programs using live, disabled virus vaccines. Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease. However their use in prepubertile females did not produce a

significant fall in the overall incidence rate of CRS in the UK. Reductions were only achieved by immunisation of all children.[citation needed] The vaccine is now usually given as part of the MMR vaccine. The WHO recommends the first dose is given at 12 to 18 months of age with a second dose at 36 months. Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus.