Rubella Virus During Pregnancy — A Complete Guide to German Measles

What is rubella during pregnancy?

Rubella (also known as German measles) is a viral illness. In most people who catch the virus, its effects are mild (especially in children). They typically last about one to five days. People who have rubella often have a rash on their body and may suffer from a fever and other symptoms of a viral illness. Sometimes rubella causes no symptoms - you might not even be aware that you’ve been infected.

If rubella symptoms usually pass quickly, why is it important to know about it? Rubella is a mild illness in most children and adults but it can be serious if infection occurs during pregnancy.

Particularly for women in the first trimester of pregnancy, rubella infection can cause a number of serious conditions in the unborn baby:

• heart defects
• brain defects
• deafness
• cataracts

In some cases, rubella infection can also be responsible for miscarriage or stillbirth. Congenital rubella syndrome (CRS) is the name given to the range of conditions that are caused in a baby who is born with the virus.

So rubella is a mild illness that can nevertheless have serious consequences if the infection is contracted during pregnancy. For this reason, it’s very important for women who are planning on becoming pregnant to be aware of the condition and the best ways of minimizing the risk of harm to their baby.

How common is rubella?

Thankfully rubella infection is now rare in the United States and in parts of the world where immunization with the MMR vaccine is common.

Despite this, there are many parts of the developing world where this vaccination program is either unavailable or poorly followed. This means that it is important to vaccinate yourself and your children against this serious illness.

The effects of German measles on mother and baby

One of the challenges of German measles is that its symptoms are often so mild they're difficult to notice, especially in children.

This means that many people may not even realize that they have this infection — they’ll often put their condition down to a simple viral infection and think nothing more of it.

This can be hazardous — when people are unaware of the infection they may be more likely to pass it to others. This risk is even greater in communities in which vaccination procedures have not been followed carefully.

Often the first sign of German measles infection is an itchy rash that begins on the face and neck and later spreads to the rest of the body.

Although the rash may initially appear as pink or light red spots, they may later join together and appear as larger patches. The rash usually passes after 3 days.

The infected person may also show the following general symptoms between two and three weeks after the exposure to measles:

• fever
• malaise
• headache
• stuffy or runny nose
• joint pain (more common in young women)
• swollen lymph nodes at the back of the head or neck or behind the ears

Swollen glands and joint pain can remain for several weeks after infection. 

Children who catch the rubella virus usually recover quickly with no after-effects. Adults can sometimes suffer from complications.

Consult your doctor if you think your baby may be infected with rubella. Because many of the symptoms of German measles are also true for other conditions, they will examine your baby and take some blood samples.

In most cases, the infection will pass within a few days and cause no after-effects. There is no need to give your baby antibiotics - rubella is a viral illness and antibiotics will have no effect upon it

Is rubella contagious?

Rubella isn’t considered to be as contagious as other infections like chicken pox, but it can still pose a risk to others. It spreads by droplet infection - this means that it is passed to others in fluids from the nose or mouth by coughing or sneezing.

A child with rubella may pass it to others from a week before the rash appears and for up to four days afterwards. If you’re pregnant, it’s safer for you to keep away from an infected child until at least a week after their rash has disappeared.

Causes of rubella in pregnancy

If you’ve been infected by the rubella virus (for example during childhood), you may have immunity to it. A more reliable way to make sure you’re not at risk of catching it is to make sure that you’ve received a vaccine against it - this is particularly true if you’re planning on becoming pregnant.

Once you’ve been vaccinated against rubella, this will prevent you from contracting the illness later in life. If you become pregnant, you can be confident that your developing baby will be protected against the harmful effects of German measles.

Ask your health professional for advice about vaccination against rubella and other infectious diseases.

Symptoms of rubella virus in pregnancy

Contact your health practitioner if think you’ve been exposed to measles while pregnant. Look out for the typical rash and any of the following symptoms:

• fever
• joint pain
• swollen lymph nodes at the back of the head or neck or behind the ears

Don’t simply turn up at your local clinic without first seeking advice from your doctor! You don’t want to expose healthy people to your infection. Once they’ve been informed, the staff at the clinic or hospital will take precautions to ensure that you won’t put others at risk while you’re being examined and treated.

Your health provider will want to take a blood test to check for immunity to the rubella virus. 

Why do I need to be screened for immunity to rubella?

The measles, mumps, and rubella (MMR) vaccine is a well-established and clinically-proven remedy for the prevention of these important 3 infections. Once you’ve been given the vaccine, a blood test will show that you’re positive for IgG - this means that you’re protected against being infected by the rubella virus.

The Centers for Disease Control (CDC) recommendations suggest that all women who are considering becoming pregnant be screened for immunity to rubella beforehand. If no immunity is detected, a woman should be vaccinated at least a month before conceiving.

Vaccination against German measles has been very effective in protecting children against the serious consequences of this illness. Although birth defects resulting from rubella infection were once much more common, vaccination has meant that they are now very rare.

Keep this in mind in your child’s early life - the MMR vaccine is usually given in two doses at around 12-15 months of age and then at 4-6 years of age.

Unfortunately, you can’t be given the rubella vaccine if you’re already pregnant. If this is the case you’ll need to be extra careful to avoid anyone with a rash or any other sign/symptoms that indicate possible infection with German measles.

Rubella treatment during pregnancy

Given the low number of rubella infections nowadays and the success in preventing it via the MMR immunization, you are generally at low risk of contracting rubella.

Nevertheless, the infections do occur in pregnancy, particularly in cases when a woman has been exposed to a highly-contagious child with measles or if vaccination procedures have not been followed.

If a blood test reveals that you have contracted the rubella virus in early pregnancy, you will be referred to a specialist who will be able to advise you about the risks to your baby.

Can rubella be treated?

There are currently no treatments available for rubella infection during pregnancy after it has occurred. However, your health practitioner may offer you a dose of immunoglobulin in the hope of reducing your baby's risk of defects. However, this won't prevent your baby from becoming infected.

How to treat German measles

In most cases the symptoms of German measles are self-limiting. This means that they will pass with time without medical treatment.

There is currently no treatment available to prevent infection once it has occurred.