Rubella (German measles) is a mild childhood disease that in the adult can cause a rash, mild fever, and arthritis (usually in women.) In pregnancy, the disease may be devastating to the unborn child, causing miscarriage or serious birth defects (including deafness, cataracts, mental retardation, heart defects, and liver or spleen damage). There is a 20% chance of damage to the fetus if the mother is exposed to Rubella in early pregnancy. Because Rubella can be spread from person to person through the air after an infected person coughs or sneezes, anyone can catch it if he/she is around someone who has Rubella.
Symptoms include a rash and fever for two to three days. Symptoms are usually mild in children and young adults.
Rubella can be prevented by the administration of the Rubella vaccine (included in the MMR injection – i.e. measles, mumps, and rubella vaccine.) In our country, the majority of outbreaks have been prevented by widespread use of immunizations. Even with aggressive education and easy access to the vaccine, there are still as many as twenty percent of pregnant women at risk of contracting Rubella during their pregnancy.
A simple blood test is available to determine if someone is immune or susceptible to Rubella. This test should be done prior to planning a pregnancy. If this test shows immunity, a woman does not have to worry about contracting the disease during pregnancy. If there is no immunity, vaccination at least 28 days prior to trying to get pregnant should be considered. A non-pregnant person may receive the vaccine anytime to assure that an unexpected pregnancy will not occur prior to trying to achieve immunity.
The majority of people who receive the vaccine will develop immunity. Although it is not necessary, a repeat blood test can be done eight weeks after the administration of the rubella vaccine to determine if immunity has been acquired due to the vaccine.
After immunization, expect some mild flu-like symptoms (slight fever, sore throat, headache, tiredness). Slight soreness, redness, or swelling at the site of the injection might also occur. Occasionally, women may experience some joint stiffness approximately two to four weeks after the vaccine is administered. This is self-limiting and requires no treatment. Women should avoid getting pregnant for at least four weeks after immunization.
Rubella testing is part of the routine lab work drawn in early pregnancy. If a pregnant woman discovers that she is not immune, she should NOT be immunized at that time. Women who remain non-immune or who discover that they are not immune to rubella after they are found to be pregnant are advised to stay away from small children, large crowds, and any ill people for the first trimester (the first twelve weeks) of their pregnancy. Rubella vaccination should be administered after delivery and is usually given during the hospital stay following delivery, just prior to discharge.
Groups who are advised to receive the Rubella vaccine:
- Women of childbearing age.
- College students, trade school students, and any other student beyond high school.
- Hospital or other medical facility workers.
- International travelers or cruise ship passengers.
- Anyone born after 1956 should have at least one dose unless they can prove they are immune or have had the disease.
Groups who are advised against receiving the Rubella vaccine:
- Pregnant women.
- Anyone who has had a life-threatening reaction to gelatin, the antibiotic Neomycin, or to a previous dose of MMR vaccine.
- Anyone moderately or severely ill.
- Anyone who has HIV/AIDS, or other immune system diseases.
- Anyone who has been on a drug which affects the immune system, such as steroids, for two weeks or longer.
- Anyone with cancer or who is taking cancer drugs or x-ray treatment.
- Anyone who has had a low platelet count (a blood disorder).
- Check with your doctor if you have received blood or blood products in order to determine when you may receive the vaccine.
Rubella occurs infrequently, but the possibility of devastating effects on the fetus warrants precautions be taken.