Rubella (German Measles)

Rubella is also called German measles or 3-day measles. It is 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 woman may lead to miscarriage or birth defects in the baby, which are the most feared complications of the infection. Women should be immunized with the MMR vaccine before pregnancy and be immune to the infection. If rubella does occur in a pregnant woman, it is 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 any woman 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 popsicles.

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. 

  • Rubella in a pregnant woman can cause miscarriage or severe birth defects in the baby. Any pregnant woman who has had contact with someone with rubella should contact her healthcare provider right away. She 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 have not already received the MMR vaccine (for measles, mumps, rubella). Adults with rubella should notify 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 seek medical advice

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

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

  • Rash turning 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

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Call 911

Call 911 for any of the following:

  • Trouble breathing

  • Stiff or painful neck

  • Unusual 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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