question:  Rubella Overview Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash. Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles. The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella. Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its reemergence. Symptoms The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about two to three days and may include: - Mild fever of 102 F (38.9 C) or lower - Headache - Stuffy or runny nose - Inflamed, red eyes - Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears - A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence - Aching joints, especially in young women When to see a doctor Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above. If you're contemplating getting pregnant, check your vaccination record to make sure you've received your MMR inoculations. If a pregnant woman contracts rubella, especially during her first trimester, the virus can cause death or serious birth defects in her developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It's best for women to be protected against rubella before pregnancy. If you're pregnant, you'll likely undergo a routine screening for immunity to rubella. But if you've never received the vaccine and think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you're already immune. Causes The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from a pregnant woman to her unborn child via the bloodstream. A person with rubella is contagious from 10 days before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it. Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults. The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant. Complications Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. Diagnosis The rubella rash can look like many other viral rashes. So doctors usually confirm rubella with the help of laboratory tests. You may have a virus culture or a blood test, which can detect the presence of different types of rubella antibodies in your blood. These antibodies indicate whether you've had a recent or past infection or a rubella vaccine. Treatment No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. Lifestyle and home remedies In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. 