Rubella (German Measles)

Rubella is also called German measles or 3-day measles. It's a viral illness that most often affects children who have not received the rubella vaccine (MMR vaccine). It can also infect adults who never had rubella and have never received the vaccine.

Rubella is generally a mild illness that lasts about 3 to 4 days. Symptoms include a mild rash and low fever. They may also include headache, runny nose, muscle aches, and swollen glands in the neck. Rubella is spread through the air or by direct contact with a sick person.

Infection with rubella in a pregnant person may lead to miscarriage or birth defects in the baby, which are the most feared complications of the infection. People should be immunized with the MMR vaccine before pregnancy (at least 1 month before) and be immune to the infection. If a pregnant person isn't immune, the MMR vaccine should not be given until after the baby is born. If rubella does occur in a pregnant person, it's an important public health concern. For this reason, the healthcare provider is required to report this illness to the public health department. Public health staff may contact you as part of their investigation. Their goal is to control a possible outbreak.

Home care

  • Keep your child home from school or daycare for at least 1 week after the rash first started. Keep the child away from anyone who might be pregnant.

  • Ask your child's healthcare provider before giving any over-the-counter medicines.

  • Fever increases water loss from the body.

    • For infants younger than 1 year: Continue regular feedings (breast or formula). Between feedings give plain oral rehydration solution. Ask your healthcare provider for a recommendation.

    • For children 1 year or older: Give plenty of fluids like water, juice, gelatin, water, non-caffeinated soda, ginger ale, lemonade, or ice pops.

    • Don't be concerned if your child isn't interested in food. Adequate fluid intake is most important when your child has a fever.

Preventing spread of the virus

  • Rubella is contagious from 7 days before to 7 days after the rash appears. 

  • Up to half of people with rubella infection have no symptoms. These people can still spread the virus.

  • Until the contagious period has passed (7 days after the rash appears):

    • Children should stay home from school or daycare.

    • Adults should stay home from school or work. 

    • Pregnant people should stay away from anyone who's contagious

  • Rubella in a pregnant person can cause miscarriage or severe birth defects in the baby. Any pregnant person who has had contact with someone with rubella should contact their healthcare provider right away. They should be evaluated for rubella infection.

  • If your child has been in school or daycare during the contagious period, notify the facilities. They can advise parents to have their children vaccinated if they haven't already had the MMR vaccine (for measles, mumps, rubella). Adults with rubella should tell their workplace and any other contacts.

Follow-up care

Follow up with the child's healthcare provider, or as directed by our staff.

When to get medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if any of these occur:

  • Your child has a fever (see "Fever and children" below)

  • The rash turns dark purple

  • Earache, sinus pain

  • Headache

  • Repeated diarrhea or vomiting

  • Signs of dehydration: No wet diapers for 8 hours in infants, little or no urine in older children, very dark urine, or sunken eyes

  • Symptom get worse or new symptoms occur

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow the provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Call 911

Call 911 for any of the following:

  • Trouble breathing

  • Stiff or painful neck

  • Abnormal fussiness, drowsiness, or confusion

  • Fast breathing: 

    • Over 40 breaths per minute for children less than 3 months old

    • Over 30 breaths per minute for children over 3 months old

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