Rubella Information

RUBELLA (German Measles)
Rubella infection during pregnancy can seriously damage an unborn baby. This damage is easily preventable by ensuring that all women have immunity well before each pregnancy.

What is Rubella?
Rubella which is also known as German Measles is a viral infection. When a person has been in contact with Rubella, it takes two or three weeks to develop symptoms. The person may feel off-colour for a few days. Symptoms are generally mild and may include:

  • Red pink rash, if it develops will usually start on the face and neck and spread to the body;
  • Fever;
  • Joint pains (more common in adults);
  • Swollen lymph glands around the head and neck;
  • The symptoms of rubella usually last about three days and up to 50% of people may have no symptoms at all so may have the disease without being aware. Recovery from Rubella is usually complete.

How is Rubella spread?
Rubella is very easily spread by droplets in the air through coughs and sneezes or by direct contact with a person’s nose and throat secretions. Anyone with no immunity can catch rubella.  It can take two to three weeks to develop symptoms. A person with rubella can spread the virus from one week before symptoms develop until four days after the rash appears.

In Australia, cases of Rubella continue to occur and are often linked to travel to a country that does not offer routine rubella immunisation.

When is Rubella dangerous?
Rubella is dangerous when women are infected during the early stages of pregnancy, especially during the first sixteen weeks. The virus can cause miscarriage, stillbirth or severe damage to the unborn baby.

The earlier in pregnancy the mother is infected, the more severe the damage to the baby is likely to be. If a woman catches rubella during the first 8-10 weeks of her pregnancy the risk of the baby being affected by Congenital Rubella Syndrome (CRS) is as high as 90% and the baby is likely to develop multiple birth defects.  By the 11th and 16th week of pregnancy the risk of CRS occurring falls to around 10 to 20% and it is likely that affected babies will have fewer birth defects.

Rubella infection in the mother after 16 weeks rarely results in birth defects and deafness is the most commonly reported problem if infection occurs at this stage.

How can Rubella affect the unborn baby?
A baby whose mother contracts Rubella early in pregnancy can be born with a range of defects which is given the collective name of Congenital Rubella Syndrome (CRS).

The virus seems to affect the cells of parts of the baby’s body that are developing at the time the mother is infected. Possible abnormalities which can result can include deafness, blindness, heart and brain damage or damage to the nervous system.

Possible abnormalities which can result can include:

  • Sensorineural deafness (www.hearing.com.au/types-hearing-loss)
  • Blindness (cataracts in one or both eyes as well as other visual conditions)
  • Congenital heart disease (the heart does not develop in the right way)
  • Brain damage (the brain may not develop fully)
  • Intrauterine growth retardation
  • Inflammatory lesions of the brain, liver and bone marrow may occur.

Contact your doctor if you are pregnant and think you may have been in contact with a person who has Rubella.

Can Congenital Rubella Syndrome be prevented?
The best way to prevent Congenital Rubella Syndrome is by all women making certain they have immunity to Rubella well before each pregnancy.   Immunisation and having a blood test is the most effective way of ensuring this. A blood test for Rubella antibodies is recommended before each pregnancy.

To reduce the risk to pregnant women it is important for the whole community to be immunised.

What vaccine protects against Rubella?
MMR (Measles, Mumps, Rubella) vaccine protects against Rubella. It is a combination vaccine which also protects against measles and mumps. The vaccine contains small amounts of reduced strength Measles, Mumps and Rubella viruses and a small amount of antibiotic (neomycin).  The aim of Rubella vaccination is to stop the circulation of the Rubella virus in the community and thereby the risk of a child being born affected by Congenital Rubella Syndrome.

Who should have MMR vaccine

  • In Australia all children are given a first dose of MMR vaccine as part of the National Immunisation Program at age 12 months and a second dose which is combined with varicella (chicken pox) at 18 months of age. All women planning a pregnancy should check their immunity and have the vaccine at least one month before conception if required.
  • The recommendation of the Department of Health is that everyone should have two doses of MMR vaccine. Any individual born during or since 1965, who has no evidence of having had either the vaccines or all three diseases should speak to their healthcare provider.
  • Childcare and Healthcare workers are advised to ensure they have been immunised.
  • MMR vaccination is also recommended for travel to many world regions (check with your doctor).   Download a MMR vaccination postcard.
  • People from Asia and Africa who have entered Australia after the age of routine vaccination are advised to seek vaccination. A Rubella containing vaccine is not offered in many parts of the world particularly in the Asian and African countries.

Due to good immunisation coverage in Australia, the incidence of Rubella is low. However there is no room for complacency.  If the numbers of children/people vaccinated begins to fall, Rubella incidence will begin to increase.

How safe is the MMR vaccine?
MMR is a very safe and effective vaccine. Reactions to the vaccine are much less frequent and severe than the complications of the disease. The most common reactions include feeling unwell, low grade fever, possible rash six to eleven days after immunisation.   Swelling of the facial glands is possible after three weeks due to the mumps component of the MMR vaccine.

At the rate of approximately one in a million doses, a more serious reaction, inflammation of the brain, can occur.

Who should not be vaccinated?
MMR vaccine should not be given to anyone who:

  • Is pregnant (and pregnancy should be avoided for one month following vaccination);
  • Is unwell on the day of vaccination;
  • Has had a severe reaction to any vaccine;
  • Has a severe allergy;
  • Is taking steroids;
  • Has had immunoglobulin or a blood transfusion in the last three months;
  • Has a disease or treatment which causes low immunity;
  • Lives with a person who has a disease which causes low immunity;
  • Has a condition of the central nervous system which is still being investigated.

How can Rubella be treated?
There is no specific treatment for Rubella as the symptoms are generally mild. Anyone who develops Rubella should avoid contact with women who may be pregnant

Where can I get additional help?
Contact your healthcare provider or Victorian Government Immunisation Program.

Tel 1300 882 008;
www.health.vic.gov.au/immunisation
Australian Department of Health: www.immunise.health.gov.au

The Rubella Antibody Test explained
A Rubella Antibody Test will determine if you have had a recent or past infection, or if you have never been exposed to the Rubella virus. A test for Rubella IgG and IgM antibodies will assist the doctor to determine if you are at risk of becoming infected with, or if you are protected against, the virus.

Rubella infection during early pregnancy can lead to severe damage in the unborn baby. The symptoms of Rubella appear two to three weeks after infection. If you are pregnant and develop a rash along with other symptoms, your doctor will request a Rubella antibody test to help make a diagnosis. There are many reasons for developing a rash and having a blood test is the only reliable way of knowing if it is Rubella.

Women who are planning a family are strongly advised to have a Rubella antibody test before pregnancy and to be vaccinated at least one month before starting a pregnancy if there is no evidence of immunity to the virus. If there is a low level of antibody the test may be inconclusive in which case immunisation may be recommended as a precaution.

Rubella Resource Order Form

Information about Rubella is also available on one DVD that contains 19 languages.
The languages on the DVD are:
English, Albanian, Amharic, Arabic, Burmese, Cambodian, Dari, Dinka, Hakka Chin, Hindi, Karen, Manadarin, Nuer, Oromo, Persian, Somali, Tamil, Tigrinya and Vietnamese.

Download a pamphlet in your own language:
Amharic
Arabic
Chin
Chinese
Dari
Dinka
English
Karen
Khmer
Kirundi
Somali
Vietnamese

For further information, contact your doctor.