Rubella (German measles) in pregnancy

What is rubella?

Rubella, commonly known as German measles, is an infection that affects the skin and lymph nodes. It is caused by a virus. Rubella is serious in pregnant women because of the effect it can have on an unborn child.

What are the symptoms of rubella?

When children get rubella, it is usually a mild illness. Sometimes they have no symptoms at all, but they can still spread the infection to others.

Symptoms may include:

• A low-grade fever and mild aches and pains, sometimes red eyes. 
• A rash of pink or light red spots that start on the face and spread down to the rest of the body.
• Neck glands may swell up and feel tender, especially behind the ears.

The sickness lasts about 3 days and generally gets better on its own without any complications. In teens and adults, rubella can be a more serious disease. Joint pain is common. 

How is rubella spread?

The rubella virus passes from person to person through droplets from the nose or throat of someone with rubella. These droplets may land in the nose or mouth of someone who is close by, especially when the infected person coughs or sneezes.

Rubella is most contagious a few days before and after the rash appears.

What about pregnant women and rubella?

Rubella in pregnancy is now very rare in Canada because most women have been vaccinated against it. 

• If a pregnant woman gets rubella during the first 20 weeks of pregnancy, she usually passes the disease on to her unborn baby. The baby will have congenital rubella. Babies with congenital rubella are contagious for more than a year. 
• If the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many life-long problems. The most common are eye problems, hearing problems and damage to the heart.
• If the fetus gets rubella between 12 and 20 weeks of pregnancy, problems are usually milder.
• There are rarely problems if the fetus gets rubella after 20 weeks of pregnancy.

There is no treatment for rubella infection.

What can you do to prevent rubella while you are pregnant?

If you've had the rubella infection or have been vaccinated, you are likely protected.

• If you aren’t sure if you had a rubella vaccine, you should have a blood test before you get pregnant. The test will tell you if you are protected against rubella. 
• If a blood test shows you are not protected against rubella, you should get the MMR vaccine right away. The vaccine should be given at least 4 weeks before you become pregnant. You cannot get this vaccine when you are pregnant.
• If you are already pregnant and do not know if you are protected against rubella, ask your doctor to test you. If you are not, avoid close contact with people who have rubella, and those who have had a rash for less than a week unless a doctor has told them that the rash is something other than rubella.
• If you are not immune, you should be vaccinated as soon as possible after your baby is born, before leaving the hospital.