Infectious diseases


Last update: 16-01-2024

How else can it be called?

  • German measles

  • Three-day measles

  • ICD-10: B06

What is rubella?

Rubella is a contagious viral infection caused by the rubella virus that results in a skin rash.

Since the widespread childhood vaccination with the triple viral vaccine (rubella - measles - mumps), rubella has become rare, and its symptoms can now be easily mistaken for those of other viral infections.

Rubella is usually mild in children, but more severe in adults and poses a high risk for pregnant women as it can lead to serious complications, including congenital rubella syndrome.

What causes rubella?

Rubella is a disease caused by the virus of the same name, which belongs to the Rubivirus genus of the Togaviridae family. It is a contagious disease that spreads through the sneezing and coughing of an infected person.

The infection can be transmitted starting one week before the onset of the initial symptoms of the disease.

What are the main symptoms of rubella?

The main symptoms of the rubella surface after an incubation period of 14 to 21 days. Initial symptoms include:

  • Malaise
  • Red eyes
  • Sore throat
  • Painful swelling of the neck glands

Subsequently, a skin rash appears, characterized by small pink or reddish spots on the skin that may cause mild itching.

It begins on the face and neck, gradually spreading to the trunk and limbs as facial lesions fade. The rash typically persists for approximately 3 days.

It's worth noting that up to 40% of children may not present any type of rash.

Additionally, if rubella occurs in adults, it commonly causes:

  • Fever
  • Headache
  • Nasal congestion
  • Muscular stiffness and pain
  • Joint pain
  • Testicular pain in men

How is rubella diagnosed?

The diagnosis of rubella is very important in pregnant women, which is why blood tests are usually performed to detect recent antibodies against the virus.

Moreover, the newborn is closely monitored through laboratory tests to evaluate the progression of the infection.

In other individuals, the diagnosis is made based on the clinical history of contact with sick people and the manifestation of various symptoms, with particular attention to the characteristic rash associated with the disease.

How can it be prevented?

There is a vaccine for rubella, utilizing an attenuated virus. Its administration is recommended between approximately 12 and 15 months of age and is often combined with immunization against measles and mumps (MMR vaccine). A booster dose is typically given at 3 or 4 years of age.

It is crucial to avoid contracting rubella or being vaccinated against it during the first trimester of pregnancy, as there is a high risk of miscarriage or the baby being born with congenital rubella syndrome. This syndrome can lead to serious conditions such as blindness, hearing loss, heart defects, or intellectual disability.

Surviving children may also face chronic and challenging conditions like autism, diabetes mellitus, and thyroid diseases.

The risk of these malformations depends on the timing of rubella infection during pregnancy, with generally no adverse effects if the infection occurs after 16 weeks of pregnancy.

Since the typical rash of the disease may not always be present, the diagnosis of the infection may be uncertain. However, when there is suspicion that an unvaccinated child or adult may have rubella, appropriate isolation measures, including the use of masks and handwashing, should be implemented. Total avoidance of contact with pregnant women, especially in the early stages of pregnancy, is essential.

Which is the recommended treatment?

It is a benign disease that typically resolves on its own without the need for treatment, with recovery expected within approximately one week. Following the infection, individuals gain permanent immunity, preventing future occurrences of the disease.

Anti-inflammatory medications can be administered for pain relief, while paracetamol or ibuprofen may be used to reduce fever or alleviate discomfort.

Complications are extremely rare but can include thrombocytopenia (a decrease in the number of platelets) or brain infection (encephalitis), necessitating specialized care in a hospital.

In pregnant women, treatment often involves the use of immunoglobulins to try to mitigate the effects of the infection on the fetus, with outcomes varying widely.

Medically reviewed by Yolanda Patricia Gómez González Ph.D. on 16-01-2024


  • Principles and Practice of Clinical Virology (5th Ed) 2004, Jennifer M. Best and Jangu E. Banatvala, ISBN: 0-470-84338-1, Pag. 427.
  • Fitzpatrick’s Dermatology in General Medicine (8th Ed) 2008, Lowell A. Goldsmith, Stephen I. Katz, Barbara A. Gilchrest, Amy S. Paller, David J. Leffell, Klaus Wolff, ISBN: 978-0-07-171755-7, Pag. 2340.
  • Nelson Textbook of Pediatrics. Chapter 274 - Rubella. ELSEVIER. ISBN: 978-0323529501.
  • Rubella. World Health Organization. 4 October 2019. Available on:

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