German measles or rubella (roo-BEH-luh) is a viral illness that causes a rash.
Rubella is caused by the virus of the same name. The word rubella comes from the Latin word for “little red,” which originally described the infection's telltale rash. It is commonly known as German measles and three-day measles because of its short duration.
German measles infection usually is not serious. Most people have mild symptoms and a faint rash. However, if a woman develops rubella during the early stages of her pregnancy, it can cause miscarriage * , premature delivery * , and multiple birth defects, known as congenital (konJEH-nih-tul) rubella syndrome (CRS). Babies born with CRS may have cataracts * and other eye problems, microcephaly * , intellectual disabilities, deafness, heart defects, enlarged liver or spleen, and other problems.
In the United States, the disease was widespread before the rubella vaccine was introduced. A rubella epidemic *
The illness is contagious and spreads through contact with tiny drops of fluid from the mouth and nose of someone who is infected. The droplets leave the mouth and nose when the person sneezes, coughs, or talks. Then other people may inhale the drops, or the drops may fall on something that other people touch. Once people get the droplets on their hands, they can infect themselves by touching their mouth or nose. The virus enters through the mucous membranes * there and takes hold in the body. Pregnant women can also pass the infection to the fetus * in the womb. Infants born infected are said to have congenital rubella syndrome (CRS), which causes a range of birth defects.
Symptoms of the illness are often mild, particularly in children. In fact, between one-third and one-half of all cases may not even be identified as German measles because the symptoms go unnoticed, or cannot be distinguished from those of a common mild respiratory illness such as a cold.
Children with German measles usually develop a distinctive rash. It starts on the face as pink or light red spots and then spreads to the body. The rash is fainter than a measles rash, usually does not itch, and lasts from one to three days. Older children and adults may have symptoms of a viral illness before the rash appears, including swollen lymph nodes * (particularly in the area behind the ears and in the back of the neck), mild fever, runny nose, and conjunctivitis * . Adults also may experience joint and muscle pain and stiffness along with their other symptoms.
If a patient is suspected of having rubella, the doctor can confirm the diagnosis by taking samples of fluid from the mouth or nose with a swab. Samples of blood and rarely, cerebrospinal fluid * , may be collected as well. All of these are examined for signs of the virus. The blood sample also may be tested for antibodies * to the virus.
There is no treatment for the disease, and it is generally so mild that specific treatment is unnecessary. Over-the-counter medications such as acetaminophen can lower a fever and ease pain in the muscles and joints. Infants born with CRS are treated for any defect they have developed.
Most patients recover completely in one to two weeks, and in many patients, the disease runs its course in as little as three days.
Complications tend to occur more often in adults than in children. Temporary arthritis * , which can last up to a month, is common in adults who have German measles. Rare complications include encephalitis * , neuritis * , and abnormal bleeding. If the infection occurs in a pregnant woman, it can lead to miscarriage, premature delivery, or congenital rubella syndrome in the baby.
Vaccination * is the best way to prevent German measles infection. The vaccine for German measles is given as part of a combined vaccination for measles * , mumps * , and rubella called MMR. Children receive the MMR vaccine in two doses, usually at age 12 to 15 months and 4 to 6 years, usually before entering kindergarten. Doctors recommend that women who are old enough to have children be tested for immunity * to German measles, and if the woman is not immune to the virus, she should be vaccinated.
See also Congenital Infections • Encephalitis • Pink Eye (Conjunctivitis) • Vaccines and Immunization • Viral Infections
McNeil, Donald G., Jr. Rubella Has Been Eliminated from the Americas, Health Officials Say. New York Times, April 29, 2015. http://www.nytimes.com/2015/04/30/health/rubella-has-been-eliminatedfrom-the-americas-health-officials-say.html (accessed March 16, 2016).
Centers for Disease Control and Prevention. “Rubella (German Measles, Three-Day Measles).” http://www.cdc.gov/rubella/index.html (accessed March 16, 2016).
Merck Manual, Consumer Version. “Rubella (German Measles, 3-Day Measles).” http://www.merckmanuals.com/home/children-s-healthissues/viral-infections-in-infants-and-children/rubella (accessed July 14, 2016).
Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-232-4636. Website: http://www.cdc.gov (accessed March 16, 2016).
World Health Organization. Avenue Appia 20, 1211 Geneva 27, Switzerland. Telephone: 41-22-791-21-11. Website: http://www.who.int (accessed March 16, 2016).
* miscarriage (MIS-kare-ij) is the end of a pregnancy through the death of the embryo or fetus before birth.
* premature delivery occurs when a baby is born before it has reached full term.
* cataracts (KAH-tuh-rakts) are areas of cloudiness of the lens of the eye that can interfere with vision.
* microcephaly (my-kro-SEH-fahlee) is the condition of having an abnormally small head, which typically results from having an underdeveloped or malformed brain.
* epidemic (eh-pih-DEH-mik) is an outbreak of disease, especially infectious disease, in which the number of cases suddenly becomes far greater than usual.
* fetus (FEE-tus) is the term for an unborn human after it is an embryo, from nine weeks after fertilization until childbirth.
* mucous membranes are the thin layers of tissue found inside the nose, ears, cervix (SER-viks) and uterus, stomach, colon and rectum, on the vocal cords, and in other parts of the body.
* lymph nodes (LIMF) are small bean-shaped masses of tissue containing immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.
* conjunctivitis (kon-jung-tih-VYtis), often called pink eye, is an inflammation of the thin membrane that lines the inside of the eyelids and covers the surface of the eyeball.
* cerebrospinal fluid (seh-ree-bro-SPY-nuhl) is the fluid that surrounds the brain and spinal cord.
* antibodies (AN-tih-bah-deez) are protein molecules produced by the body's immune system to help fight specific infections caused by such microorganisms as bacteria and viruses.
* arthritis (ar-THRY-tis) refers to any of several disorders characterized by inflammation of the joints.
* encephalitis (en-seh-fuh-LYE-tis) is an inflammation of the brain, usually caused by a viral infection.
* neuritis (nuh-RYE-tis) is an inflammation of the nerves that disrupts their function.
* vaccination (vak-sih-NAY-shun), also called immunization, is giving, usually by an injection, a preparation of killed or weakened germs, or a part of a germ or product it produces, to prevent or lessen the severity of the disease caused by that germ.
* measles (ME-zuls) is a viral respiratory infection that is best known for the rash of large, flat, red blotches that appear on the arms, face, neck, and body.
* mumps is a contagious viral infection that causes inflammation and swelling in the glands of the mouth that produce saliva.
* immunity (ih-MYOON-uh-tee) is the condition of being protected against an infectious disease. Immunity often develops after a germ has entered the body.