Topic: Rubella
Description
Rubella is a mild illness caused by the rubella virus. However, rubella is serious because it can produce defects in children born to women who are infected by the virus during pregnancy. Congenital rubella syndrome (CRS) occurs in up to 90% of infants born to women who are infected with rubella during the first trimester of pregnancy. The risk of a single congenital defect falls to approximately 10%-20% by the 16th week. From the 20th week of pregnancy defects are rare. The most common defects to occur are deafness, cataracts and other vision problems, inflammation of the brain, heart defects, liver disease, bone disease and growth retardation.
Symptoms
Symptoms of rubella may include a generalised rash and fever, arthritis or painful joints, headache, swollen lymph glands (especially at the back of the neck), cough, runny nose and conjunctivitis. Children often present with few or no symptoms while adults may have a fever, loss of appetite and feel generally unwell from five to 10 days before onset of the rash. Inflammation of the brain (encephalitis) is a rare complication, occurring more frequently in adults than in children. However up to 50% of rubella infections show no symptoms
The rash usually lasts three to five days and, if fever is present, the fever usually settles on the first day of the rash.
Since the introduction of an effective vaccine, rubella mainly occurs in young unimmunised children, or in adolescents and young adults who have received less than two doses of MMR vaccine.
Rubella is highly contagious. It is spread by droplets from the nose and throat through coughing or sneezing, or by direct contact with infectious people.
The usual time between contact with the virus and the development of the illness is approximately 14 to 17 days, although sometimes it can take longer.
A person is infectious from seven days before the onset of the rash until at least four days after the rash appears.
Treatment
Symptoms of the rubella virus can generally be treated with rest, plenty of fluids, and paracetamol to reduce fever or pain. Your local doctor can provide you with advice.
If a pregnant woman at 20 weeks gestation or less has been in contact with the rubella virus, she should consult her doctor for blood tests and counselling.
People with rubella should stay away from child care, school or work until fully recovered and until at least four days after the onset of the rash.
It is very important that a person with rubella stays away from crowded areas such as shopping centres, and also keeps away from pregnant women during the infectious period.
Health Outcome
Rubella is generally a mild infectious disease. The major concern is that rubella can produce defects in children born to women who are infected by the virus during pregnancy. The principle aim of the rubella vaccination is to prevent this occurring by stopping the circulation of the virus in the community.
Prevention
Rubella can be prevented with vaccination. The rubella vaccination is offered as part of a combined Measles, Mumps and Rubella (MMR) vaccine and is recommended for all children at 12 months of age and again at four years of age.
The MMR vaccine is also recommended for:
- non-pregnant non immune women of childbearing age and they should be advised not to become pregnant for 28 days after vaccination
- female immigrants, especially those from Asia are likely to require vaccination
- women should be tested for immunity two months after vaccination and revaccinated if necessary
- males, especially those born from 1966 to 1985, are especially likely to be non-immune to rubella and should be vaccinated with two doses of MMR.
Help and Assistance
For further information please contact your local doctor, community health centre or nearest population health unit.
Other Resources
Department of Health and Ageing - Conditions and Diseases
Related Content
Rubella and immunisation fact sheet
Footnotes
Heymann, D., ed. 2004. Control of Communicable Diseases Manual, 18th edition. Washington, DC: American Public Health Association, pp 464-468.
National Health and Medical Research Council, 2003. The Australian Immunisation Handbook (9th Ed.) Canberra: National Capital Printing.
Last Updated: 12th October, 2009
Date Valid to: 30th June, 2010
