By: Capt. Sarah Caron, DO & Lt. Col. Megan Donahue, MD, FAAP
Rubella is a contagious infection that is caused by a virus. It has been mostly gone from the U.S. since 2004. Preventing rubella is important because travelers can bring it to the U.S. and spread it to unvaccinated people. A rubella infection during pregnancy can cause miscarriage or serious problems for the baby.
In the United States, we haven't seen rubella much in recent decades. That's thanks to the measles, mumps and (MMR) vaccine.
Recent measles outbreaks in unvaccinated people are a reminder of why we still need the MMR vaccine.
Getting the MMR vaccine will prevent your child from getting sick and spreading rubella to a pregnant woman. Read on to learn more about rubella symptoms, how it spreads and when to get the MMR vaccine.
What is the difference between rubella and measles?
Rubella is sometimes called "German measles" or "three-day measles." Both rubella and measles are known to cause a rash and other symptoms. Rubella is not the same as
measles, though, and is caused by a different virus (rubeola).
Rubella rash and other symptoms in children
|
|
Rubella rash |
Rubella infections in children are usually mild. Children with rubella may have a red rash that starts on the face, spreads to the rest of the body and tends to last about 3 days. Red spots in the mouth can show up 1-5 days before the rash.
Other symptoms of rubella can include:
swollen lymph nodes at the back of the neck and behind the ears
itchy eyes, a fever, cough, headache, runny nose and body aches
joint pain, which is more common for teenagers and adults (especially women) and less common in children
A person can spread rubella to others as early as 1 week before the rash appears. They are contagious for 7 days after getting the rash. It spreads when an infected person coughs or sneezes. People can infect others even if they do not have any symptoms.
Pregnancy and congenital rubella syndrome
A rubella
infection while pregnant can have devastating effects. It can cause miscarriage, stillbirth or death of the baby in the womb. Or your child could have birth defects that lead to congenital rubella syndrome (CRS).
Infants born with CRS are usually infected during the first trimester. This is a serious condition that can affect a child's quality of life. CRS is one of the few known causes of autism.
|
|
A "blueberry muffin" rash is a type of rash that some babies get if they are infected with rubella in the womb. |
The birth defects include eye issues such as deafness or
hearing impairment, cataracts and loss of eyesight,
heart defects, learning problems, enlarged liver and spleen, brain issues, a smaller head than expected (also called
microcephaly), lung issues, bone problems, bleeding problems, and a "blueberry muffin" rash.
A baby with CRS is usually considered contagious for at least 1 year. Child care providers and others who are not immune to rubella are at risk if they are exposed to a baby with CRS.
When do children get the rubella vaccine?
In the U.S., the rubella vaccine is available in combination with vaccines against measles and mumps (MMR vaccine) and in combination with MMR and chickenpox (varicella) (MMRV vaccine).
Children get two doses of vaccine. The first dose is at age 12-15 months (typically as the
MMR vaccine). They get a second dose at age 4-6 years or before entering school (as MMR or MMRV vaccine).
Getting both doses of the MMR vaccine allows for lifelong immunity.
Get the rubella vaccine before or after pregnancy
The MMR vaccine cannot be given during pregnancy. It is important to be vaccinated before you are pregnant if you were not vaccinated as a child or do not know your status. The vaccine must be given at least 1 month before you become pregnant.
You are considered protected against rubella after at least 1 to 2 doses of a rubella-containing vaccine
and a
blood test that indicates you are immune.
If you had a rubella vaccine in the past but your
test did not show immunity, get the vaccine before you become pregnant. There is no need to get another test to check your immunity after the vaccine.
Your partner/spouse should get the rubella vaccine if they have not received it.
If you are not immune to rubella and are currently pregnant, get the vaccine after your baby is born before you leave the hospital.
If you are exposed to rubella while pregnant and are not sure if you are immune, ask your doctor for a blood test right away.
What if my baby is too young for the rubella vaccine?
Infants less than 1 year of age are at high risk of getting rubella because they are too young to be vaccinated.
It is important to limit travel outside of the United States if your baby is not vaccinated. If you must travel, talk to your pediatrician about ways to protect your child on your trip and check for health advisories on the Centers for Disease Control and Prevention
Travel Health Notices webpage. Depending on your plans, vaccines may be recommended before you go.
What to do if your child has a rubella infection
There is no medication to cure a rubella infection. To help your child feel better, make sure they get plenty of rest, stay hydrated and treat
fever and pain as needed.
Take steps to avoid spreading the virus to others.
Your child should stay home from child care, school or work for 7 days after the rash first appears.
Wash hands with soap and hot water and use alcohol-based hand sanitizer.
To kill the virus, clean then
disinfect surfaces and items with a 1%
bleach solution or 70% ethanol (ethyl alcohol). Check the label on the bottle and follow instructions on how to dilute the product.
Remember
Getting vaccinated can protect yourself and others. After one dose of the MMR vaccine, 95% of people show immunity to rubella. Two doses will provide closer to 100% lifelong protection.
More information
About Dr. Caron
 Capt. Sarah Caron, DO, is a first-year pediatric resident at the San Antonio Uniformed Services Health Education Consortium. Her interests are in tropical diseases and preventable infectious diseases.
|
About Dr. Donahue
 Lt. Col. Megan Donahue, MD, FAAP, is board-certified in Pediatrics and Pediatric Infectious Diseases. She is the Division Chief for Pediatric Infectious Diseases at Brooke Army Medical Center and the Associate Program Director for the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Pediatrics Residency. Her interests are in medical education and tropical infectious diseases.
|
The views expressed in this manuscript are those of the author(s) and do not necessarily reflect the official policy or position of the Defense Health Agency, the Department of Defense, nor any agencies under the U.S. Government.
