What is rubella?

Rubella, also known as German measles, is a disease caused by the rubella virus.

Rubella is usually a mild illness but can be very serious for pregnant women and their developing babies. If a pregnant woman contracts rubella, she may have a miscarriage or stillbirth. Her baby may be born with severe birth defects, including deafness, eye problems, heart defects, liver, spleen and brain damage. This is called Congenital Rubella Syndrome (CRS). CRS occurs in about 9 out of 10 babies born to women who have rubella infection in the first 3 months of pregnancy. CRS is rare because so many women are immune to rubella infection due to routine immunization. Cases still occur in Canada, however, in babies born to women who immigrate to Canada as rubella immunization is not routine in many parts of the world.

Is there a rubella vaccine?

There are 2 vaccines available in B.C. that provide protection against rubella:

1. Measles, Mumps, Rubella (MMR) Vaccine
2. Measles, Mumps, Rubella and Varicella (MMRV) Vaccine

The vaccines are free as part of routine childhood immunizations and to others that need protection against rubella. For more information, see:

• HealthLinkBC File #14a Measles, mumps, rubella (MMR) vaccine
• HealthLinkBC File #14e Measles, mumps, rubella and varicella (MMRV) vaccine

What if I am planning on getting pregnant?

If you are a woman of childbearing age, make sure you are immune to rubella before getting pregnant. If you are not immune (you have not had the disease or been immunized), you should get the MMR vaccine, and then wait 1 month before getting pregnant.

What if I am already pregnant?

If you are pregnant and do not know if you are immune to rubella, you will be offered a blood test for rubella immunity as part of your prenatal care. If you are not immune, you should be immunized after your pregnancy, preferably before leaving the hospital. Rubella vaccine should not be given during pregnancy as a general precaution of avoiding live vaccines in pregnancy. If a woman receives rubella vaccine during her pregnancy, this is not a reason to terminate the pregnancy. The vaccine has never been found to cause Congenital Rubella Syndrome.

How is rubella spread?

Rubella is spread by contact with saliva or mucus from the mouth, nose or throat of an infected person. When an infected person coughs or sneezes, the virus spreads through droplets in the air. You can become infected when you breathe in these droplets or touch objects contaminated with the virus. Sharing food, drinks or cigarettes, or kissing someone who has the virus can also put you at risk.

What are the symptoms?

Symptoms may include a rash, fever, joint aches, headache, discomfort, runny nose and irritated eyes. The lymph nodes located behind the ears and at the back of the neck may swell and feel painful.

The rash, which may be itchy, begins first on the face and then moves downwards from the head to the feet, and lasts about 3 to 5 days. About half of all rubella infections show no symptoms of a rash.

Symptoms can appear 14 to 21 days after a person is infected with the rubella virus. In most cases, symptoms appear 14 to 17 days after exposure to the virus.

What if I have been exposed to rubella?

If you have been exposed to someone with rubella and you have not had the disease or 1 dose of a rubella vaccine, you should get immunized to protect yourself against future exposure to the rubella virus. Contact your health care provider to schedule an appointment to get your immunization.

Pregnant women who may have been exposed to rubella should speak with their health care provider to determine if they are immune to rubella. Pregnant women who have been exposed to rubella and are not immune will need blood tests to determine if they have been infected.

What should I do if I think I have rubella?

If you have fever and a rash and think you may have rubella, especially if you have been in contact with someone with rubella or traveled to an area with a rubella outbreak, have yourself examined by a health care provider. It is best to call ahead so that you can see your health care practitioner quickly and without infecting other people. Rubella can spread easily in places like waiting rooms and emergency rooms. The doctor or triage nurse can make sure that you are taken into a closed area for an examination and attend the clinic at a time when the waiting room is empty. Bring your immunization record with you. A physical examination, blood test, and throat swab or urine sample will be collected to make the diagnosis of rubella.

How can I prevent spreading rubella to others?

A person with rubella can spread the virus to others from 7 days before to 7 days or more after the rash first appears. If you have rubella, you can help prevent spreading it to others, especially pregnant women, by:

• Staying at home for 7 days after the rash first appeared
• Washing your hands regularly
• Coughing or sneezing into a tissue or sleeve rather than your hands
• Not sharing food, drinks or cigarettes, or kissing others

What is the home treatment?

After seeing a health care provider, the following home treatment tips may help you to be more comfortable while you rest and recover.

• Drink plenty of fluids such as water, juice and soup, especially if you have a fever
• Get plenty of rest
• Treat the fever (if there is one)