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Rubella

German Measles · 3-day Measles · Three-day Measles

Symptoms and Complications

The main symptom of rubella is a red rash, usually starting on the head and neck. The rash doesn't appear until 14 days to 21 days after infection. Rubella tends to be as regular as clockwork, and most people develop their rash on the 17th or 18th day after exposure.

Some people experience a prodrome (warning symptoms), which appears as swollen glands, particularly behind the ear, general aches, and fatigue. These symptoms last from one to five days before the rash appears and are more common in children than in adults. Once the rash appears, the fever resolves.

The rash usually consists of small red or pink spots. It may be itchy. It tends to spread down the body, disappearing from the head as it reaches the trunk. It usually lasts about three days. Other possible symptoms include:

  • cloudy eyes
  • headache
  • low fever (not more than 102°F or 39°C)
  • mild conjunctivitis (pinkeye)
  • runny nose

Some people have no symptoms at all. It's unknown how many rubella infections go unnoticed and unreported.

You're infectious from one week before the rash appears until two weeks after it disappears. This means, of course, that people can transmit rubella before they know they have it.

The most common complication associated with rubella is the development of a mild form of arthritis that usually goes away on its own. It seems to be more common in adults and particularly more common in adult females then adult males.

There are rare complications that can occur: 1 in 3000 cases in children may go on to develop major bleeding complications and 1 in 5000 cases in adults may go on to develop encephalitis (infection of the brain).

A serious complication of rubella occurs when it infects pregnant women. There is a high risk of major birth defects or miscarriage if a woman contracts rubella in the first three months of pregnancy. After three months, the risk begins to fall, and it's almost unknown for a baby to have problems if the mother catches rubella after the 20th week of pregnancy. Problems observed in children born to infected mothers include:

  • bone marrow defects
  • cataracts
  • deafness
  • growth retardation
  • liver and spleen problems
  • malformations of the heart
  • unusually small brain or brain damage

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