Rubella: What You Need to Know About the “German Measles.”

When people hear the word rubella, many think of a harmless childhood illness. After all, it’s often called “German measles” and usually comes with mild symptoms. But here’s the reality: rubella can be devastating for unborn babies if a mother is infected during pregnancy. That’s why rubella is not just another childhood rash—it’s a public health concern with worldwide efforts to eliminate it.

In this article, we’ll explore what rubella is, how it spreads, its risks, testing and treatment, vaccines, and what the WHO’s certification of rubella elimination really means. By the end, you’ll understand why rubella is more than a rash and why vaccination campaigns are critical in protecting future generations. 

What Is Rubella?

Rubella is a contagious viral infection caused by the rubella virus. Unlike measles, which can cause severe illness, rubella is often mild—sometimes so mild that people don’t even realize they have it.

Common nicknames:

• “German measles” (because it was first described by German doctors in the 18th century)

• “Three-day measles” (because the rash typically lasts about three days)

But don’t be fooled by the gentle nicknames. While rubella usually isn’t life-threatening in healthy children or adults, it poses a serious danger during pregnancy. Infection in early pregnancy can lead to miscarriage, stillbirth, or a cluster of severe birth defects known as Congenital Rubella Syndrome (CRS).

Symptoms of Rubella

The tricky thing about rubella is that about half of all infections show no symptoms at all. When symptoms do appear, they’re often mild and include:

• Pink or red rash starting on the face and spreading to the body

• Low-grade fever

• Swollen lymph nodes (especially behind the ears and at the back of the neck)

• Joint pain, especially in women

• Runny nose, mild cough, or sore throat

The rash usually lasts three days, but swollen glands and joint discomfort may stick around longer. Because symptoms overlap with other viral illnesses, lab tests are often needed for confirmation.

How Does Rubella Spread?

Rubella spreads through respiratory droplets—tiny particles released when an infected person coughs, sneezes, or even talks. You can also catch it by touching contaminated surfaces and then your mouth, nose, or eyes.

Key facts about rubella transmission:

• People are contagious one week before the rash appears and up to one week after it fades.

• Even people with no symptoms can spread it.

• Outbreaks are more likely in communities with low vaccination rates.

Why Is Rubella Dangerous in Pregnancy?

Rubella may be mild for most people, but for unborn babies, it’s another story. If a pregnant woman contracts rubella, especially in the first trimester, the virus can cross the placenta and affect the developing fetus.

This can cause Congenital Rubella Syndrome (CRS), which may lead to:

1. Deafness
   Hearing loss is one of the most common outcomes of Congenital Rubella Syndrome, often permanent and affecting speech and learning development.

2. Blindness or cataracts
   Rubella can damage the developing eyes, leading to cloudy lenses (cataracts) or even blindness if left untreated.

3. Heart defects
   Babies may be born with structural heart problems such as patent ductus arteriosus (PDA), which can require surgery or lifelong care.

4. Intellectual disabilities
   Congenital Rubella Syndrome can interfere with brain development, leading to learning difficulties and challenges with daily functioning.

5. Growth problems
   Many infants with Congenital Rubella Syndrome are born with low birth weight or may face delayed physical growth and development over time.

Congenital Rubella Syndrome is devastating not only for the child but also for families and communities. That’s why rubella elimination is a global health priority.

Diagnosis and Testing

Because rubella looks like other viral rashes, doctors usually rely on lab tests.

• Blood test (IgM and IgG antibodies): Helps confirm recent or past infection.

• PCR test: Detects the virus’s genetic material.

For pregnant women, testing is crucial if they’ve been exposed to someone with rubella or if symptoms appear.

Treatment for Rubella

Here’s the good news: rubella usually resolves on its own without specific treatment. Most people recover in about a week.

Treatment focuses on relieving symptoms:

• Rest and hydration

• Pain relievers for fever or joint pain

• Isolation to prevent spread

There’s no antiviral medication for rubella—but there is an effective way to prevent it: vaccination.

The Rubella Vaccine: Your Best Protection

The rubella vaccine is a safe, effective, and long-lasting shield against the disease. It’s almost always given as part of a combination vaccine:

• MMR (Measles, Mumps, Rubella)

• MMRV (Measles, Mumps, Rubella, Varicella)

Vaccine Schedule

• Children: First dose at 12–15 months, second dose at 4–6 years.

• Adults: Anyone who missed childhood vaccination, especially women of childbearing age, should get at least one dose.

The exact schedule may vary slightly between countries depending on their national immunization program, but the two-dose approach is widely recommended by the World Health Organization (WHO).

Effectiveness

• One dose: about 95% effective.

• Two doses: provides lifelong protection for most people.

Professional tip: Women should avoid becoming pregnant for at least one month after getting the rubella vaccine.

Global Efforts to Eliminate Rubella

Rubella elimination is within reach thanks to vaccination campaigns worldwide. Countries that achieve sustained low transmission can apply for WHO certification of rubella elimination.

What Does WHO Certification Mean?

When WHO “certifies elimination” of rubella in a country or region, it means:

1. No endemic rubella cases have been reported for at least three years.

2. The country has strong surveillance systems to detect and confirm cases quickly.

3. High vaccination coverage is maintained to prevent reintroduction.

It’s important to note that “elimination” doesn’t mean the virus is gone everywhere (that would be eradication, like smallpox). Instead, it means the virus no longer spreads naturally in that area. Imported cases may still occur, but they don’t lead to ongoing outbreaks.

For example, the Americas became the first WHO region to eliminate rubella in 2015. Since then, other regions have been working toward the same milestone.

Why Vaccination Coverage Matters

For rubella elimination to succeed, at least 95% of the population needs to be vaccinated. This creates herd immunity, making it harder for the virus to spread—even if someone brings it in from outside.

When vaccination rates drop, outbreaks can return quickly. We’ve seen this happen in some countries where vaccine hesitancy has led to resurgences.

Rubella in Numbers (as of 2025)

• Before vaccines, rubella caused millions of infections and thousands of Congenital Rubella Syndrome cases annually.

• Today, rubella cases are at historic lows in many regions thanks to vaccines.

• However, outbreaks still occur in countries with lower vaccination rates.

Frequently Asked Questions (FAQs)

1. Is rubella the same as measles?
No, they’re different viruses. Rubella is usually mild, while measles can be severe.

2. Can adults get rubella?
Yes. Anyone unvaccinated or without prior infection is at risk, including adults.

3. Can rubella come back in countries that eliminated it?
Yes, if vaccination coverage drops, imported cases can spark outbreaks.

4. What’s the best way to protect unborn babies?
Make sure all women of childbearing age are immune to rubella before pregnancy.

Conclusion: Why Rubella Still Matters

Rubella may seem mild, but its impact on unborn babies makes it a serious global health concern. With safe and effective vaccines, rubella and Congenital Rubella Syndrome are entirely preventable.

The WHO’s certification of elimination is a big deal because it signals that a country has broken the chain of local transmission. But this achievement can only be sustained with high vaccination coverage and strong surveillance.

The bottom line? Rubella is preventable. Vaccination doesn’t just protect you—it protects future generations. By staying up-to-date with immunizations, you’re contributing to a world where rubella is no longer a threat.

Related Articles:
1. Vaccines: What They Are and Why They Matter to You
2. MMR Vaccine: What Every Parent and Adult Should Know
3.Measles in Children: What Happens and How to Manage It
4. Measles Was Eliminated in the US in 2000. Why Are We Seeing Outbreaks Again?

Sources:

 World Health Organization (WHO) – Rubella
https://www.who.int/news-room/fact-sheets/detail/rubella

 Centers for Disease Control and Prevention (CDC) – Rubella
https://www.cdc.gov/rubella/index.html

 Mayo Clinic – Rubella (German Measles)
https://www.mayoclinic.org/diseases-conditions/rubella/symptoms-causes/syc-20377310

 National Health Service (NHS UK) – Rubella
https://www.nhs.uk/conditions/rubella/

 Johns Hopkins Medicine – Rubella
https://www.hopkinsmedicine.org/health/conditions-and-diseases/rubella-german-measles