Rubella, or German measles, is usually a mild disease. However, rubella can have serious consequences for children and pregnant women. Rubella infection will normally last from 1 week before until 4 days after the onset of the rash, if there is no serious complication.

Common symptoms of rubella

These are usually mild symptoms and include fever, swollen glands, joint pain and a red rash around the ears and neck.

Complications of rubella

These are usually serious conditions and include a tendency to bleed or bruise (thrombocytopenia), deafness and inflammation of the brain (encephalitis), which could result in hospitalisation.

Congenital rubella (which means rubella infection of an unborn child) is a very serious condition. If a woman catches rubella during the first 3 months of her pregnancy, the virus almost always causes serious birth defects (congenital abnormalities) in her unborn child. This can include deafness, blindness, heart defects or damage to the brain.

The table below compares the potential problems caused by rubella with the potential problems caused by the MMR vaccine.

Green - Common, usually mild symptoms that can be treated at home.

Yellow - Moderate complications that need medical attention but may not include hospitalisation.

Red - Serious complications that need urgent medical attention and could include hospitalisation.

Potential risks in a group of 100 children under 5 years of age who get rubella

rubella-no-vaccine

50 children will have the common and usually mild (in green) symptoms of rubella e.g. fever, tiredness, sore eyes, rash, painful and swollen glands.

Potential risks in a group of 100 children who have the MMR vaccine

rubella-mmr

Most will have common and usually mild (in green) symptoms of the MMR vaccine e.g. pain or swelling at the injection site, joint pain and stiffness. Some may have more than one of these symptoms at the same time.

Some may have more than one of these symptoms listed above at the same time (in yellow) 14 in 100 may have moderate
(in yellow) symptoms
- 4 may have high fever
- 4 may be irritable
- 1 may have swelling of salivary glands
- 5 may have a non-infectious faint red rash

Rare complications

1 in 3,000 children may have a temporary tendency for bruising or bleeding (thrombocytopenia)

Rare complications

25 to 34 in 100,000 children may have fever-induced fits or convulsions

1 in 6,000 children may have inflammation of the brain (encephalitis). Encephalitis from any reason may result in children surviving with permanent brain damage or death

90% of babies infected in the first trimester (i.e. first 3 months of pregnancy) will have major birth defects (congenital abnormalities) such as deafness, blindness, heart defects or damage to the brain.

Very rarely, a person may get degenerative brain inflammation i.e. progressive rubella pan-encephalitis

1 in 1 million children may have inflammation of the brain (encephalitis). Encephalitis from any reason may result in children surviving with permanent brain damage or death

Up to 4 in 1 million children may get a severe allergic reaction (anaphylaxis). Anaphylaxis from any reason, may result in death

Up to 4 in 100,000 children may have a temporary tendency for bruising or bleeding (thrombocytopenia)

Copyright University of Leeds and NCIRS 2019 - Last updated 20 September 2019

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