What is rubella?

Rubella is a contagious illness caused by a virus. Rubella is also known as ‘German measles’, but it is different to the illness caused by the measles virus. Some people with rubella do not have symptoms at all. For others, infection can cause a mild illness with fever and a red rash.

Rubella is usually not dangerous. But babies, of people who catch rubella during pregnancy, can be seriously affected. Rubella is now rare in Australia thanks to childhood vaccination programs. Outbreaks can still occur among people who are not immune.

This page focuses on advice for adults and children aged above 5 years. You can find information about rubella during pregnancy and in babies and younger children on the Pregnancy, Birth and Baby website.

What are the symptoms of rubella?

About 1 in every 2 people who catch rubella do not have any symptoms. People without symptoms can still spread the infection to others.

People with rubella who feel unwell usually notice symptoms about 2 – 3 weeks after contact with a person infected with the virus.

Symptoms are usually mild, and include:

• red rash
• mild fever
• headache
• swollen glands
• runny nose
• joint pain
• sore red eyes

Most people with symptoms recover in about 3 days.

What causes rubella and how is it spread?

A virus causes rubella. Rubella spreads through contact with an infected person’s breathing fluids, for example, if they cough or sneeze nearby. Rubella can also spread through direct contact with an infected person.

In pregnant people, rubella can travel in their blood and infect their developing babies. Babies who become infected during pregnancy can spread rubella after they are born. This is through their breathing fluids and urine. It can happen for months or potentially more than a year.

If you have rubella, it is important to stay home from childcare, school or work to stop you spreading the infection to others. Rubella stops being contagious when you are completely well, or 4 days after you first see the rash — whichever is first.

Ask your doctor if you are unsure when it is safe for you or your child to return to work or school.

Rubella is a notifiable disease. This means that a doctor who diagnoses rubella needs to report it to the local health authorities. It is important for local health authorities to know about cases of rubella in the community. This is so they can take steps to control an outbreak and protect people who may be at risk.

Who is at risk of getting rubella?

Anyone of any age can catch rubella if they are not immune. You are immune to rubella if you have been sick with it in the past or received a course of rubella vaccinations. In Australia, people born before 1966 are generally considered to be immune because it is likely that they caught rubella in childhood.

What should I know about rubella and pregnancy?

Rubella can be harmful to developing babies if their mothers become infected — especially during the first 10 weeks of pregnancy. Rubella infection during pregnancy can lead to a condition called congenital rubella syndrome (CRS). This syndrome can cause a range of birth defects.

About 9 out of 10 babies, born to people who catch rubella during the first trimester of pregnancy, become affected by CRS.

Birth defects associated with CRS include:

• low birthweight
• cognitive impairment
• hearing loss
• heart problems
• eye problems, such as cataracts

Rubella vaccination is not recommended during pregnancy. If you are planning a pregnancy, see your doctor for a pre-conception health check. This usually includes making sure that you are immune to infections like rubella. Your doctor will check your vaccination history and sometimes refer you for a blood test. It is also a good opportunity to ask about any vaccines recommended for you before you try to conceive.

When should I see my doctor?

You should see your doctor if you think you or your child may have rubella. It is important to get a diagnosis from a doctor, as many other illnesses have symptoms like rubella.

Since rubella is contagious, it is important to call ahead before you visit your doctor. This is so the staff can arrange for you to sit away from other patients in the clinic. Ask your doctor about the possibility of a home visit or telehealth appointment, such as a phone or video call.

Most cases of rubella are not dangerous and get better on their own. If you or your child have severe symptoms, or have concerns about your health, see your doctor. Severe symptoms may also be a sign that you have an illness other than rubella that may need medical treatment.

If you are pregnant and you think that you may have rubella or may have had contact with an infected person, see your doctor or midwife urgently for advice.

To schedule a video call with a maternal child health nurse from the Pregnancy, Birth and Baby team, click here. Video call is a free service and is available from 7am to midnight (AET), 7 days a week (including public holidays).

How is rubella diagnosed?

Your doctor will ask you about your symptoms and examine your rash. They may also ask if you think you have had contact with anyone who has rubella. Your doctor will ask you about your vaccination history.

If your doctor suspects that you may have rubella, they may refer you for a blood test to confirm the diagnosis. They may also refer you for other tests to rule out illnesses with similar symptoms.

How is rubella treated?

There is no specific medicine or treatment for rubella. Antibiotics will not help you recover from rubella faster because a virus, and not bacteria, causes rubella. Antibiotics are for treating infections caused by bacteria.

Most people recover from rubella by themselves without medical treatment.

Strategies to try to relieve your symptoms at home include:

• getting plenty of rest
• drinking lots of fluids
• taking paracetamol to relieve fever

How can I prevent rubella?

Vaccination is the best way to prevent rubella.

The rubella vaccine is a combination vaccine for measles, mumps and rubella (MMR) or measles, mumps, rubella and varicella (MMR-V). Both are very effective and have similar side effects. Your doctor can advise which vaccine is right for you.

MMR and MMR-V vaccinations do not cause autism. Medical and scientific experts have completely discredited any research that might have suggested a link between the MMR and MMR-V vaccines and autism.

Children have 2 doses of rubella-containing vaccine. It is free on the National Immunisation Program Schedule at 12 and 18 months of age.

If you were born during or after 1966, and have not had the rubella vaccine, speak to your doctor about getting vaccinated. This is especially important if you are old enough to become pregnant, or planning a pregnancy. Rubella vaccination is also strongly recommended for people who work in childcare or healthcare.

The rubella vaccine is not recommended for women who are already pregnant or people who have a weakened immune system.

What complications can come with rubella?

Rubella does not usually cause complications except in unborn babies. In very rare cases, rubella may cause joint inflammation (arthritis) or neurological problems.

If you have rubella and are experiencing severe symptoms, speak to your doctor.

Resources and support

• For more information about immunisation in Australia, visit the Department of Health Immunisation website.
• For more information about birth defects, visit the Australian Birth Defects Society.
• The Sharing Knowledge About Immunisation website has videos and other tools to help you make decisions about immunisation and your family.