Rubella (German measles) is a contagious viral illness that is generally mild, causing a fever, rash and swollen lymph glands. However, if contracted by mothers during the first 10 weeks of pregnancy, the disease can cause major congenital abnormalities in up to 90% of infected babies.
Although increased vaccination rates have led to a steady decline in the number of rubella cases in Australia, it is important that women considering becoming pregnant should be checked for rubella immunity and vaccinated if necessary. Checking for immunity to rubella during pregnancy is also recommended.
The rubivirus that causes rubella is spread from person to person through direct contact with respiratory droplets from an infected person and through droplets in the air.
Symptoms of rubella take between 14 and 23 days after infection to show. These symptoms are generally mild (especially in children) and may include: a rash, lymphadenopathy (swollen lymph glands), and joint pain. About half of all patients will develop a rash and swollen glands, while half of adolescents and adults will have painful joints.
Complications are rare and include encephalitis (brain infection) and low levels of white cells and platelets in the blood. Becoming infected with rubella during the first 10 weeks of pregnancy can cause severe abnormalities in the developing baby, such as deafness, blindness, heart defects and intellectual disabilities.
Vaccination provides effective protection against the rubella virus and can reduce the number of babies born with abnormalities. Rubella is highly contagious and the best way to protect expectant mothers and their babies is to make sure women are immunised before they become pregnant, and to immunise all children to stop the spread of infection.
Rubella vaccination is recommended as part of routine childhood immunisation. Rubella is free under the National Immunisation Program Schedule. To receive rubella immunisation, visit your local doctor or immunisation provider. It is important to note that although the vaccine is provided at no cost, a consultation fee may apply.
Immunisation against rubella is achieved using the MMR (measles-mumps-rubella) and MMRV (measles-mumps-rubella-varicella) combination vaccines. The first dose is given at 12 months of age as the MMR vaccine and the second dose is given at 18 months of age as the MMRV vaccine.
Women should be screened for rubella antibodies when planning a pregnancy, or early in the pregnancy irrespective of a previous positive rubella antibody result. If rubella antibody levels are low, these women should receive MMR vaccine either at least 28 days before becoming pregnant or shortly after delivery and before discharge from the maternity unit. Women should not receive the vaccine if they are pregnant or might become pregnant within 28 days.
- For information about immunisation in your area, contact your state or territory health department.
- For further information on routine childhood immunisation, refer to the understanding childhood immunisation booklet.
- For technical information or information about vaccines, refer to the rubella section of the Australian Immunisation Handbook 10th edition 2013.
- For more information on the MMRV vaccine for parents please see the MMRV parent brochure.
- For more information on the MMRV vaccine for immunisation providers please see the MMRV information for providers booklet.