Rubella

About Rubella

Rubella, also known as German measles, is a viral infection that can cause a rash, fever and joint pain. Rubella is now rare in Australia due to routine vaccination.

In most people, rubella causes no or mild symptoms. However, infection during pregnancy can cause miscarriage, stillbirth or serious birth defects in the baby.

Symptoms of rubella

Symptoms usually appear 2 to 3 weeks after exposure to the rubella virus. These may include:

• mild fever
• headache
• runny nose
• sore or red eyes
• a rash, that usually starts on the face and spreads to the rest of the body
• swollen glands, especially behind the ears and at the back of the neck
• joint pain.

Complications of rubella

While most people with rubella make a full recovery, some people can have complications such as:

• joint pain that may last for several weeks
• middle ear infection (otitis media)
• inflammation of the brain (encephalitis), which is rare but can be serious.

The most serious complications occur when rubella infection happens in pregnancy.

Congenital rubella

Congenital rubella occurs when infection happens during pregnancy and the virus passes to the baby. It can lead to miscarriage, stillbirth or birth defects in the baby.

The risk is highest during the first 10 weeks of pregnancy and declines later in pregnancy. About 9 in 10 babies exposed to rubella in early pregnancy will develop one or more serious health problems.

Health problems associated with congenital rubella can include:

• hearing loss or deafness
• eye problems or blindness
• heart defects
• developmental delays
• poor growth
• damage to other organs such as the brain, liver, spleen, bones and lungs and blood abnormalities.

If you are pregnant and think you may have been exposed to rubella, contact your doctor as soon as possible. Testing and preventive treatment may be recommended.

How rubella spreads

Rubella virus can spread from an infectious person through droplets from the nose or mouth, such as from coughs or sneezes, or from mother to baby.

Babies born with congenital rubella may shed the virus from their nose, throat and urine for up to 12 months after birth.

People at higher risk of rubella

While rubella is rare in Australia, cases can still occur. People who are more at risk of rubella include:

• people who have not received 2 doses of rubella-containing vaccine
• travellers to or from countries where rubella is more common
• healthcare and childcare workers
• Pregnant women and their babies are most at risk of serious complications.

Diagnosis of rubella

Symptoms and signs of rubella are similar to many other viral infections.

Your doctor may diagnose rubella based on your symptoms, vaccination history and recent travel or exposure to someone with rubella. Diagnosis is usually confirmed through testing of blood samples, nose and throat swabs or urine samples.

Treatment for rubella

There is no specific medical treatment for rubella. Most people recover with:

• rest
• drinking plenty of fluids
• taking paracetamol for fever or pain if required.

Antibiotics do not work against rubella because it is caused by a virus.

If you are pregnant and have rubella, your doctor will discuss care and treatment options or refer you to relevant specialists.

Prevention of rubella

Vaccination is the best way to protect yourself and others against rubella. Two doses of a rubella-containing vaccine provide long-lasting protection.

In Australia, rubella vaccine is available as part of the:

• measles, mumps, rubella (MMR) vaccine
• measles, mumps, rubella and varicella (MMRV) vaccine, available for people up to 14 years of age.

Free rubella-containing vaccines are available for eligible people through the National Immunisation Program and Victorian Government-funded programs. Vaccines are available from GPs, community pharmacies, Aboriginal Health Services and local council immunisation services.

Check your vaccination history

You can check you vaccination history by:

• accessing your records through the Australian Immunisation Register (AIR)
• contacting your doctor or immunisation provider.

Read more about how to find your immunisation records.

People who should be vaccinated

In Victoria, free rubella-containing vaccines are available through:

National Immunisation Program:

• Routine childhood vaccination at aged 12 months (MMR vaccine) and 18 months (MMRV vaccine).
• Catch up vaccination in people aged up to 20 years who are not fully vaccinated.
• Refugees and humanitarian entrants aged 20 years and over.

Victorian Government-funded program:

• People born during or since 1966 who do not have evidence of receiving 2 documented doses of a rubella-containing vaccine or serological proof of immunity. This includes people planning pregnancy or after childbirth who are not immune to rubella.
• Infants aged 6 to less than 12 months travelling overseas. If an infant receives the MMR vaccine before 12 months of age, they still require doses at 12 and 18 months as part of routine childhood vaccination.

Medicare eligibility is not required to receive a Victorian Government-funded vaccine.

Pregnancy and rubella vaccination

If you are planning a pregnancy, speak with your doctor about checking your immunity to rubella. If you are not immune, vaccination is recommended before pregnancy. You should avoid becoming pregnant for at least 28 days after receiving a rubella-containing vaccine.

Rubella-containing vaccines should not be given during pregnancy.

If you are pregnant and not immune to rubella:

• avoid contact with anyone who has rubella
• seek medical advice immediately if you think you may have been exposed.

Vaccination can be given after your baby is born if you are not immune to rubella.

People who work in healthcare or with children

Healthcare workers, childcare workers and early childhood educators are more likely to be exposed to infectious diseases.

Keeping your vaccinations up to date helps protect you and the people you care for, including pregnant women and young babies.

If you have rubella or have been exposed to rubella

If you have rubella

Stay home avoid contact with other people, particularly pregnant women, young babies and people with a weakened immune system until 7 days after the rash first appears and you are feeling well. Do not go to work or public places during this time while you are infectious.

Children with rubella must not attend primary school and children’s services until they have fully recovered and at least 7 days have passed since the rash started.

If you have been exposed to rubella

If you have had contact with someone with rubella, monitor for symptoms for up to 23 days after exposure. Contact your doctor if you develop symptoms.

If you are pregnant and not immune to rubella, or you are unsure of your immunity, contact your doctor immediately. You may be recommended testing and preventive treatment.

If you need medical care, call ahead before attending a clinic or hospital and wear a mask to help prevent spreading infection to others.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Virtual Emergency Department
• Urgent Care Clinics – when immediate healthcare is needed but it's not life-threatening
• Your GP (doctor)
• Nurse-on-Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Local government immunisation service
• Maternal and Child Health Line Tel. 13 22 29 (24 hours, 7 days)
• Immunisation Program, Victorian Department of Health
• National Immunisation Information Line Tel. 1800 671 811
• SAEFVIC Tel. 1300 882 924 – to report an unexpected or serious reactions to vaccination