Rubella, also known as German measles or three-day measles, is an acute viral infection. Before a rubella vaccine became available in 1969, there were outbreaks of the disease every six to nine years. Now rubella is rare in locations where vaccination is standard practice. In the United States, for example, there were only between 128 and 192 cases reported annually throughout the 1990s and 4 to 11 cases per year of congenital rubella syndrome, a syndrome that may occur in a fetus and which is linked with serious birth defects and developmental delay.

What Causes It?

A virus causes rubella. It can be spread in airborne droplets, such as from a cough or sneeze, from an infected person. Individuals can be contagious for as much as one week before a rash erupts and up to one week after it disappears. Infants with congenital rubella syndrome (see section entitled Special Considerations for explanation) may spread rubella virus in respiratory secretions and urine for up to two years.

Who's Most At Risk?

These factors increase the risk for rubella:

Signs and Symptoms

Symptoms are usually mild. In up to half of all cases, the disease is so mild that there are no detectable symptoms. The most distinctive sign of rubella is swollen lymph nodes behind the ear, in the neck, and at the back of the head. A rash is usually the first sign in younger children. In older children and adults, it is more common to have a low-grade fever, malaise (feeling unwell), loss of appetite, swollen glands, and upper respiratory infection for one to five days before the onset of full-blown disease.

Other signs and symptoms include:

What to Expect at Your Provider's Office

Healthcare providers will perform an exam to look for common signs and symptoms, and may perform blood tests or culture a sample of fluid from the nose or throat to check for the rubella virus.

Treatment Options


The rubella vaccine causes immunity in 90% to 95% of those who receive it. Children should receive two doses (usually as part of the combination measles-mumps-rubella [MMR] vaccine) at least 4 weeks apart. Anyone born in or after 1957 should have at least one dose of MMR. Persons born before 1957 are considered immune. Women of childbearing age should still be vaccinated prior to becoming pregnant (or demonstrate that they are immune to the virus via a laboratory test) even if they were born before 1957. (Having had rubella makes a person immune for life.)

Controversy surrounds the MMR vaccine because of concern that it may be linked to disorders such as autism and inflammatory bowel disease. However, a population-based study investigating a potential association between the incidence of autism and the introduction of the MMR vaccine in the United States and Britain did not confirm any link between the two.

Rubella vaccine should not be given to anyone who:

Treatment Plan

There is no specific therapy to fight the rubella virus. Treatment is supportive, and the infection generally resolves on its own. Complications are rare. Individual symptoms, such as fever, arthritis, and joint pain, may be treated.

Drug Therapies

Complementary and Alternative Therapies

Due to the controversy surrounding routine MMR vaccination, some people may seek alternative treatments in place of vaccination. However, there is no evidence that any CAM method confers immunity against rubella. Some CAM approaches may help alleviate symptoms of rubella.

No clinical trials have investigated the use of specific foods or nutrients to treat rubella. However, the following nutrients may be used to support the immune system in general: In addition, a laboratory study found that honey helped fight the rubella virus in test tubes; however, it is not clear what ingredient in the honey is responsible for this anti-viral activity nor is it known whether this same benefit would be conferred to people.

The value of treating rubella with herbal therapies has not been explored in scientific studies. However, to treat viruses in general, herbalists may recommend remedies that stimulate the immune system and that have fever-reducing and anti-infectious properties; in addition, agents that improve symptoms of rubella may be considered. These may include: Homeopathy
There have been few studies examining the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for rubella based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Acupuncture
Electroacupuncture (in which acupuncture points are stimulated with electrodes) successfully treated two cases of visual and hearing impairments linked to congenital rubella syndrome (see section entitled Special Considerations for explanation about this condition). Acupuncture may also help relieve arthritis pain.

Prognosis/Possible Complications

Most people who have rubella recover completely without permanent side effects and are immune to rubella afterward. This is not the case for a fetus infected in the womb. Fetal infection can cause serious long-term effects (see section entitled Special Considerations).

Complications are more common in adults than children and may include:

Special Considerations

If a fetus is infected with rubella in the womb, this can cause severe defects known as congenital rubella syndrome. The younger the fetus is at the time of infection, the more likely the syndrome is to occur and the more severe the effects are likely to be. Temporary effects of congenital rubella syndrome may include: Permanent effects of congenital rubella syndrome may include:


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