German Measles (Rubella)

German measles, also called rubella, is a rare condition in the United States. With the introduction of the rubella vaccine in the late 1960s, the incidence of German measles has significantly declined. But the disease does still exist in other parts of the world. German measles is rarely threatening, but pregnant women and fetuses can suffer adverse complications.

German measles (rubella) is caused by a highly contagious virus. A patient is contagious in the week before the rash outbreak until two weeks after the rash clears. The virus is spread when you inhale or touch secretions from an infected person. The virus may be passed through the bloodstream from a pregnant woman to her fetus.

These days, German measles (rubella) is rare in the United States, thanks to vaccines that typically provide lifelong immunity. Most cases occur in immigrants born in countries where German measles is more common. Americans who have recently traveled abroad may cause outbreaks if they catch the virus and bring it home with them.

Since the rubella vaccine is given between 12 and 15 months of age, infants and young toddlers who have not received the vaccine are at greater risk of contracting German measles.

Because German measles threatens fetuses, many women who become pregnant are given a blood test to confirm immunity.

Symptoms often last three to seven days. They may include:

• mild fever (under 102 degrees Fahrenheit)
• runny or stuffy nose
• headache
• muscle pain
• inflamed or red eyes (may develop into conjunctivitis)
• swollen lymph nodes
• a pink rash that starts on the face and spreads downward

Although these symptoms may not seem serious, you should notify your doctor if you suspect that you have German measles. Since this condition is a public health threat, cases should be monitored. Your physician will work with the Centers for Disease Control and Prevention (CDC) to determine whether your individual case is part of a widespread outbreak. Medical staff will provide instructions to prevent further spread of the virus.

Complications include ear infections and brain swelling. Seek medical care if you notice any of the following during or after a German measles infection:

• prolonged headache
• earache
• stiff neck

If a woman contracts German measles during pregnancy, it can pass to her fetus through her bloodstream. This is called congenital rubella syndrome. Some affected fetuses miscarry or are stillborn. Fetuses that are carried to term may suffer from birth defects, which can include:

• delayed growth
• learning disabilities
• heart defects
• deafness
• poorly functioning organs

Women of childbearing age should have their immunity tested before becoming pregnant. If a shot is needed, it is important to get it at least 28 days before trying to conceive.

Since German measles (rubella) appears similar to other viruses that cause rashes, your doctor may confirm your diagnosis with a blood test. The test detects antibodies in your blood, which are present in infected and immune patients. Whether or not you have German measles is determined based on the levels of antibodies.

Most cases of German measles are treated at home. Your doctor may recommend that you be isolated from others to prevent the virus from spreading.

Pregnant women may be treated with antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms. But your baby may still develop congenital rubella syndrome. An infant born with congenital rubella will require treatment from specialists.

For most patients, vaccination is a safe and effective way to prevent German measles (rubella). The German measles vaccine is typically combined with vaccines for the measles and mumps, as well as varicella, the virus that causes chicken pox.

These shots are usually given between 12 and 15 months of age. A booster shot is needed between four and six years of age. Since the vaccines contain small doses of the virus, mild fevers and rashes may result. Side effects occur about in five to 15 percent of children who are vaccinated.

If you do not know whether you’ve been vaccinated for German measles, it is important to have your immunity tested, especially if one of the following applies to you:

• You are a woman of childbearing age and are not pregnant.
• You attend an educational facility.
• You work in a medical facility or school.
• You plan to travel out of the country.
• Your doctor recommends the test.

Patients with compromised immune systems, pregnant women, and women who plan to become pregnant within a month should not be vaccinated, since the virus in the shot could cause adverse reactions.