Rubella

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Rubella results in a fine, pink rash that appears on the face, the trunk (shown in image), and then the arms and legs.

Rubella, also called German measles or three-day measles, is a contagious viral infection best known by its distinctive red rash.

Rubella is not the same as measles (rubeola), though the two illnesses do share some characteristics, including the red rash. However, rubella is caused by a different virus than measles, and is neither as infectious nor usually as severe as measles.

The measles-mumps-rubella (MMR) vaccine, usually given to children in the United States twice before they reach school age, is highly effective in preventing rubella.

Because of widespread use of the vaccine, the Centers for Disease Control and Prevention (CDC) has declared rubella eliminated in the United States, but cautions parents to make sure their children are vaccinated to prevent its re-emergence.

The signs and symptoms of rubella are often so mild they’re difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about one to five days and may include:

Contact your doctor if you think you or your child may have been exposed to rubella or if you have the signs or symptoms listed above.

If you’re contemplating getting pregnant, check your vaccination record to make sure you’ve received your MMR inoculations. If you’re pregnant and you contract rubella, especially during your first trimester, the virus can cause death or serious birth defects in the developing fetus. Rubella during pregnancy is the most common cause of congenital deafness. It’s best to be protected against rubella before pregnancy.

If you’re pregnant, you’ll likely undergo a routine screening for immunity to rubella. But if you’ve never received the vaccine and you think you might have been exposed to rubella, contact your doctor immediately. A blood test might confirm that you’re already immune.

The cause of rubella is a virus that’s passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person’s respiratory secretions, such as mucus. It can also be transmitted from pregnant women to their unborn children via the bloodstream.

A person with rubella is contagious for one to two weeks before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it.

Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults.

The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you’re pregnant.

Rubella is a mild infection. Once you’ve had the disease, you’re usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis).

However, if you’re pregnant when you contract rubella, the consequences for your unborn child may be severe, and in some cases, fatal. Up to 80 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including:

The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous.

The rubella vaccine is usually given as a combined measles-mumps-rubella inoculation, which contains the safest and most effective form of each vaccine. Doctors recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school. It’s particularly important that girls receive the vaccine to prevent rubella during future pregnancies.

Usually babies are protected from rubella for six to eight months after birth because of the immunity passed on from their mothers. If a child requires protection from rubella before 12 months of age — for example, for certain foreign travel — the vaccine can be given as early as 6 months of age. But children who are vaccinated early still need to be vaccinated at the recommended ages later.

You don’t need a vaccine if you:

You typically should get a vaccine if you don’t fit the criteria listed above and you:

The vaccine is not recommended for:

If you have cancer, a blood disorder or another disease, or you take medication that affects your immune system, talk to your doctor before getting an MMR vaccine.

Most people experience no side effects from the vaccine. About 15 percent of people develop a fever between seven and 12 days after the vaccination, and about 5 percent of people develop a mild rash. Some teens and adult women experience temporary joint pain or stiffness after receiving the vaccine. Fewer than 1 out of 1 million doses causes a serious allergic reaction.

In recent years, as the number of children diagnosed with autism has risen — without a clear explanation — widespread concerns have been raised about a possible link between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the National Academy of Medicine and the CDC conclude that there is no scientifically proven link between the MMR vaccine and autism. In addition, there is no scientific benefit to separating the vaccines.

These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which happens to be about the time children are given their first MMR vaccine. But this coincidence in timing typically shouldn’t be mistaken for a cause-and-effect relationship.

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Rubella

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