Infectious Diseases

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Rubella (German measles)

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What is rubella?

Rubella, also known as German measles, is a viral infection caused by the rubella virus. Rubella mainly affects children; however it can be more severe in adults, especially pregnant women. Rubella is not often seen in Canada as childhood immunization against rubella is required upon entry to school.

How is it spread?

Rubella can be spread through direct contact with an infected person’s secretions from the nose and mouth. You can spread rubella even if you do not have symptoms. If you think you or your child has rubella, you need to let your doctor know prior to arriving for you appointment to ensure precautions are taking in the office to prevent spreading rubella to other people.

What symptoms should I watch for?

Symptoms are generally mild and include a low grade fever, swelling of the glands in the neck and sometimes a rash with small red spots resembling measles or scarlet fever. Other symptoms may include body aches, pains and swelling of the joints. Half of rubella infections occur without a rash, if a rash is present it may be itchy, and first appears on the face and may spread from head to toe. The rash may last for about three days. The symptoms of rubella can start about 14-17 days and sometimes up to 21 days after being in close contact with someone with rubella.

How do I know if I have rubella?

Your health care provider may ask you to have a blood test, or a swab taken from your throat or nasopharynx (an area at the back of your nose).

What is the treatment for rubella?

There is no medicine to treat rubella, but you can take medicine to help with the fever and aches.

How do I protect myself and others?

Vaccination is the best way to prevent rubella. Rubella vaccine in combination with mumps and measles (MMR) is routinely given soon after a child’s first birthday. A second dose is given as part of a combination vaccine for measles, mumps, rubella and varicella (MMRV) at 4-6 years of age. The vaccine is publicly funded (free) in Ontario. Proof of vaccination against measles, mumps and rubella, or a valid exemption is required by law for all children attending school in Ontario.

Anyone with rubella or suspected rubella will be excluded from school until the eighth day from when the rash started. People who are not fully immunized with 2 MMRs will be excluded from school if a case of rubella is identified in their school. People born before 1970 are considered protected from rubella because they were most likely exposed as a child. Speak to your doctor about the vaccine. If you do not have a doctor, call the Vaccine Preventable Disease Team at the health unit.

You can also help prevent the spread of rubella by washing your hands after coughing, sneezing, and going to the washroom, and before preparing foods or eating. If you do cough or sneeze, cover your nose and mouth. Do not share cigarettes or drink from the same glass, water bottle or straw as others.

Is there anything special I need to know about rubella?

If you have rubella, it is important that you stay home and away from people until the eighth day after the rash starts. If you are infected with rubella you are most infectious to other people 7 days before the rash starts to 7 days after.

What if I am pregnant or thinking of becoming pregnant?

If you are pregnant it is important to review your immunity status with your family doctor as screening pregnant women for rubella is part of the initial prenatal follow up. Most women of child bearing age have immunity to rubella, if you are thinking of becoming pregnant check your immune status as the MMR vaccine is a live vaccine and cannot be given to you during pregnancy. If you require the MMR vaccine it is important to avoid pregnancy for 4 weeks after receiving the vaccine.

What is Congenital Rubella Syndrome?

A baby born to a mother who was infected with rubella during pregnancy will have rubella congenital syndrome. When a pregnant woman catches rubella she passes the infection on to her fetus and it can damage the organs as they develop. Infection in the first 10 weeks of pregnancy causes 90% of infants to be born with defects, typically their heart, eyes, ears and brain, often in combination. Fetal defects are rare when maternal infection occurs after the 20th week of gestation.

Fetuses infected early are at greatest risk of intrauterine death and spontaneous abortion. If you think you are pregnant and have concerns about rubella speak with your health care provider immediately.

For data on the incidence of Rubella in Simcoe Muskoka and Ontario, please visit the Rubella page on the health unit’s HealthSTATS site

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