Rubella

  • What is the pathogenesis of rubella?

    Rubella is a contagious disease caused by a virus in the Togaviridae family. It is transmitted via droplets that are shed from respiratory secretions from an infected person to a susceptible individual.1,2 The virus replicates in the nasopharynx and regional lymph and then spreads throughout the body.2 In pregnant women, transplacental infection of the fetus can occur during this time, leading to fetal damage.1,2

  • How is the rubella virus manifested?

    The symptoms of rubella are often mild, and up to 50% of infections may be subclinical or inapparent.2 In children, a rash is usually the first symptom of rubella infection, and a prodrome is not common.1,2 In older children and adults, there is often a 1- to 5-day prodrome with low-grade fever, malaise, lymphadenopathy, and upper respiratory symptoms before the rash appears.2 The rash is maculopapular and usually occurs initially on the face and then progresses from head to foot.1,2 It lasts about 3 days and may be pruritic. It is fainter than the measles rash and does not coalesce. The rash may become more prominent after a hot shower or bath.2

  • What are the complications of rubella?

    If a woman contracts the disease in early pregnancy, it can be transmitted to the fetus and may result in congenital rubella syndrome (CRS). The effects on the fetus are, to a large extent, dependent on the time infection is acquired—the younger the fetus, the more severe the illness. During the first 2 months of gestation, there is a 65% to 85% chance of either multiple congenital defects or spontaneous abortion. In contrast, rubella disease during the third month is associated with a 30% to 35% chance of developing a single congenital defect, and in the fourth month there is a 10% chance of developing a single congenital defect.1,2

    • Rubella itself is generally benign; however, arthritis or arthralgia may occur in up to 70% of adult women with the disease.
    • Uncommon complications from rubella include hemorrhagic manifestations (including thrombocytopenic purpura) and encephalitis.1,2
Disease Information

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CDC Information

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VACC-1167690-0001 01/17
1. Gershon AA. Rubella virus (German measles). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol 2. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:1875–1880.
2. Centers for Disease Control and Prevention (CDC). Rubella. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:325–340. http://www.cdc.gov/vaccines/pubs/pinkbook/index.html. Accessed November 25, 2016.