We provide information and advice about the signs and symptoms, treatments, risks and complications of rubella or German measles – most importantly the potential complication for pregnant women.
What is Rubella?
Rubella, also known as German measles, is a viral infection that is characterised by a rash and caused by a virus of the togavirus group. In children it is often a mild illness and in 30 – 50% of cases there may be little or no symptoms.
German measles takes it name from the Latin word germanus which means “similar” : measles (English measles) and rubella (German measles) have similarities, though Rubella is a milder and less contagious disease than measles.
The incubation period (the time from when exposed to the virus until symptoms first appear) is 2 – 3 weeks. Rubella is infectious from 7 days before the rash appears until about a week after it disappears. It is spread by coughing and sneezing. There were several large outbreaks of Rubella in the Pacific during 2003.
The greatest danger of the disease is the harm it can do to unborn children. For women in early pregnancy, 85% of babies infected during the first eight weeks after conception will have a major congenital abnormality such as deafness, blindness, brain damage, or a heart defect. For this reason Rubella is vaccinated against in girls and boys as part of the MMR (Measles -Mumps – Rubella) vaccine at age 15 months and 4 years. (For possible MMR vaccine side effects refer to our Immunisation Schedule article.)
Any children with German measles should be kept well away from pregnant women to prevent transmission.
What are the signs and symptoms of rubella or German measles?
- It often begins with slight fever and swollen glands
- Rash begins on the face and spreads to the body
- Rash occurs most commonly on face, neck and upper chest and limbs
- Rash is comprised of small flat pink spots and lasts around five days, which may be itchy
- Aching joints
- Sore throat
- Enlarged glands high in the back of the neck and behind the ears
What is the treatment for rubella?
- Children are nursed at home.
- Notify your doctor if your child does not improve after four days
- You also need to see the doctor if you are pregnant.
- See ‘What can I do’ for comfort measures to help your child
Risks & complications of German measles
In rare cases an inflammation of the brain lining called encephalitis can occur – the symptoms of this are unsteadiness on feet, drowsiness and loss of co-ordination. Contact your doctor immediately if these symptoms appear in your child. Another complication is otitis media (middle ear infection).
The major complication is the serious damage Rubella can do to unborn children. It can cause serious birth defects, miscarriage or stillbirth, especially if it is caught by a woman during the first trimester of pregnancy (some 90% of babies born to women who contract Rubella during the first 11 weeks of pregnancy will have congenital rubella syndrome). Rubella remains dangerous to the fetus throughout the whole pregnancy.
Women who are planning to have children should have their rubella status checked by a blood test before becoming pregnant. If they have no antibodies to the virus they need to receive the vaccine and then wait at least three months before trying for a baby.
Pregnant women need to be checked for their rubella immunity status during each pregnancy. If they are found to be not immune they will be offered a rubella vaccine after the birth of their baby, to protect any future pregnancies.
What can I do for my child at home with rubella?
- Encourage your child to rest
- Keep up fluid intake
- Children can be given paracetamol syrup for fever or discomfort, checking the dose for age on the bottle.
- Give small regular meals to tempt their appetite
- If your child is itchy, dress them in cool cotton clothing, give them warm, soothing baths and apply calomine lotion.
- Keep your child away from others
- If you are pregnant, see a doctor promptly
- Warn any pregnant women with whom your child has been in contact that your child has Rubella — they should contact their midwife / doctor to confirm their own rubella immunity.
To read about the recommended vaccination programme for children in New Zealand, visit our section on Immunisation
For more information on checking your health prior to pregnancy, visit Preconception Care