Rubella

About Rubella

Rubella, also called German measles, is caused by the rubella virus. It is generally a mild disease in children, with a rash starting on the face and spreading to the body, lasting approximately 3 days. The rash is lighter colored than measles. Associated symptoms include low grade fever, headache, and lymphadenopathy, particularly in the suboccipital, postauricular, and cervical nodes. Arthritis, particularly in adult women, can occur and persist for weeks. The critical importance of rubella prevention lies in congenital rubella syndrome CRS. If a pregnant woman is infected, especially in the first trimester, the consequences for the fetus are devastating: cataracts and other eye defects, sensorineural deafness, congenital heart disease patent ductus arteriosus, pulmonary stenosis, microcephaly, intellectual disability, growth restriction, thrombocytopenic purpura, and hepatosplenomegaly. The risk is approximately 90 percent if infection occurs before 11 weeks gestation, declining to near zero after 20 weeks. CRS was a major cause of birth defects before vaccination. Norman Gregg identified the association in 1941. The rubella vaccine is part of the MMR vaccine. The WHO aims to eliminate rubella and CRS globally. Rubella elimination has been verified in many countries, and the Americas were declared free of endemic rubella in 2015.