Rubella

Rubella, commonly called German measles, is a vaccine-preventable rash illness caused by the rubella virus. It is usually a mild disease but can be severe in some cases. Rubella during pregnancy (congenital rubella) can cause severe complications, such as birth defects, miscarriage or fetal death.

Rubella is spread person to person by droplets spread while sneezing or coughing. A person is infectious with rubella from one week before and until one week after onset of the rubella rash. A pregnant person may transmit rubella to their fetus.

In children, rubella is usually mild, with few noticeable symptoms. For children who do have symptoms, a widespread red rash is typically the first sign. The rash generally first appears on the face and then spreads to the rest of the body, lasting about three days. Other nonspecific symptoms that may appear prior to the rash may include cold-like symptoms, fever, pink eye.

Most adults who get rubella usually have a mild illness, with low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body.

Many people with rubella will experience few to no symptoms.

A health care provider can diagnose rubella. A laboratory test is needed to confirm the diagnosis. Because rubella disease is eliminated in the United States, a person likely would have travelled recently to another country or been exposed to someone who recently travelled. Diagnosis in the U.S. requires consultation with HHS and CDC.

There is no treatment for rubella. Health care providers will recommend supportive care if necessary.

All children between 12 and 15 months of age should be vaccinated with the first dose of MMR (measles, mumps and rubella vaccine). A booster dose of MMR is recommended at 4 to 6 years of age. Two doses of mumps-containing vaccine are about 88 percent effective in preventing illness. Children are required to submit documentation of age-appropriate immunization against mumps to attend early child care facilities, schools and colleges in North Dakota.

• The immunization status of all children and staff at schools or early childhood facilities should be reviewed.
• During mumps outbreaks, exposed children and staff who have not been immunized should be excluded until they are vaccinated, or, if they refuse vaccination, they should be quarantine for an appropriate amount of time following exposure.
• During rubella outbreaks, the NDHHS may recommend that certain individuals receive a third dose of MMR vaccine.

Cost should not be a barrier to vaccination. The Vaccines for Children (VFC) Program provides all recommended vaccines to children who are American Indian, uninsured or underinsured, and Medicaid-eligible. Many recommended vaccines are also available for uninsured adults. Vaccines are available at your local health care provider, public health department or pharmacy.

Rubella is a highly contagious disease and poses a serious risk to pregnant people. People with rubella must be excluded from work, school, or child care until no longer infectious. Outbreak situations may also require exclusion of unvaccinated persons, as well.

For additional information about rubella, contact the North Dakota Department of Health and Human Services’ Public Health Division at 800.427.2180.

Suspected cases should be reported immediately to the North Dakota Department of Health and Human Services.

1. Centers for Disease Control and Prevention. (2020, December 31). CDC Rubella (German measles). Centers for Disease Control and Prevention. Retrieved June 28, 2023, https://www.cdc.gov/rubella/about/transmission.html.
2. Kimberlin, D. W., Barnett, E. D., Lynfield, R., Sawyer, M. H. (2021) Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics. [Management and Prevention of Infectious Diseases; Rubella] [pages 648- 655].