Rubella: What It is, Types, Causes, Symptoms, and Treatment

What is Rubella?

Rubella, also known as German measles, is a viral infection caused by the rubella (RuV) virus. It spreads through respiratory droplets released when an infected person coughs or sneezes. It typically causes a red or pink rash that starts on the face and gradually spreads to other parts of the body. Other rubella symptoms may include mild fever, headache, and fatigue, among others.

Many people recover from rubella completely without complications. However, a rubella infection during pregnancy requires medical attention to prevent complications for the mother and the unborn child, including miscarriage, stillbirth and babies with congenital defects.

What are the Various Types of Rubella?

Rubella is classified into two categories:

How Common is Rubella in India?

According to a report published by PIB, India has witnessed a notable 17% decrease in rubella cases in 2024 as compared to 2023. The number of cases have decreased dramatically after widespread vaccination campaigns to eliminate the disease completely by 2026.

However, the risk of congenital rubella syndrome (CRS) in pregnant women makes the virus a major public health concern despite recent decreases.

What are the Symptoms of Rubella?

A red rash is usually the first indication that someone is experiencing symptoms of rubella. Usually starting on the face, the rash spreads to the rest of the body over the course of 3 days.

The following additional symptoms of Rubella may also be visible:

• Mild conjunctivitis

• Nausea

• Low fever

• Headache

• Runny nose

• Sore throat

• Swollen lymph nodes

• Joint discomfort and arthritis

What Causes Rubella?

Some common causes of rubella include:

• RuV Virus: An individual gets rubella when they come in contact with the rubella virus. This virus gets into the respiratory tract and then spreads throughout the body.

• Respiratory Droplet Transmission: When someone with the rubella virus coughs, sneezes, or talks, they release droplets that people inhale, leading to the spreading of the disease.

• Mother-to-Foetus Transmission: If a pregnant woman has the rubella virus, she can pass it to her baby through the placenta, which is called congenital rubella syndrome (CRS)

What are the Risk Factors of Rubella?

The factors that can increase the risk of getting the rubella virus include:

• Not Getting Vaccinated: People who do not get the MMR vaccine are not protected against rubella and are more likely to get infected.

• Contact with Infected People: Being around someone who has the rubella virus is a risk factor. People living with or caring for someone who has the rubella virus are more likely to get infected.

What are the Complications of Rubella?

Complications of rubella include:

• Arthritis: It can develop in up to 70% of women who contract rubella.

• Miscarriage: If an unvaccinated individual contracts rubella while pregnant, they may suffer from miscarriage.

As rubella can affect pregnant women, the virus can also affect unborn children in the womb. Complications might occur both during pregnancy and after delivery. The virus can be transmitted to the unborn child, who may experience severe birth abnormalities that can lead to long-term complications, such as the following:

Rubella can rarely result in severe complications like bleeding issues and brain infections.

When Should I See a Healthcare Provider?

Seek medical attention promptly if you notice the following symptoms of rubella:

• If you recently came in contact with a person who is infected with the rubella virus.

• Low fever, mild conjunctivitis, and swollen lymph nodes, especially if you are not vaccinated for rubella, should be checked quickly.

• If you develop a rash and it spreads to other parts of your body, make an appointment right away.

• Pregnant women must be extra careful due to the immense risk of miscarriage and birth defects in their child. Immediately visit a doctor if you have come in contact with a rubella virus-infected person.

• Joint pain and swelling, especially in adults, can indicate rubella.

How is Rubella Diagnosed?

Doctors can use blood tests, swab tests, or urine tests to diagnose rubella. The diagnosis process includes:

Diagnostic Overview Table

How is Rubella Managed/Treated?

Rubella symptoms usually get better on their own. Your healthcare provider may suggest the following ways to manage your symptoms:

• Isolate yourself from others to reduce the spread of rubella.

• Home medications for cough and cold.

• Joint pain or swelling can be treated with NSAIDs (non-steroidal anti-inflammatory drugs).

• If you notice that a rash on your face is spreading quickly, try not to scratch. Apply a cold, wet cloth to reduce the itching.

Rubella in Pregnancy

Rubella infection during pregnancy can be serious, especially if it occurs during the first trimester. The virus can pass from the mother to the developing baby and cause congenital rubella syndrome (CRS). This may lead to birth defects affecting the heart, eyes, ears, and brain.

Pregnant women who are not immune to rubella are at the highest risk. Vaccination before pregnancy is the most effective way to prevent these complications.

What is the Prognosis for Rubella?

Rubella has a highly favourable prognosis if detected on time. Its contagious nature might cause a risk of infecting other people, and so, it's better to stay in isolation if your symptoms persist for a long time.

If you get rubella when you are pregnant, you must consult a healthcare professional right away to understand the next steps of treatment to ensure your and the unborn baby’s health.

How Can I Prevent Rubella?

The MMR (or MMRV) vaccination is the most effective method of preventing rubella. MMRV offers protection from rubella, mumps, chickenpox, and measles.

Additional strategies to prevent rubella include:

• Frequently wash your hands, particularly if you are ill.

• Don’t share personal belongings with others, such as spoons or cups.

• When you cough or sneeze, cover your nose and mouth.

• When travelling, be aware of the prevalence of infectious diseases such as rubella at your location.

• Consult your healthcare practitioner about rubella prevention if you intend to become pregnant. If you were not vaccinated as a child, they usually advise getting immunised at least one month before you attempt to conceive.

Does Health Insurance Cover Rubella?

Yes. Most health insurance plans in India cover the treatment cost of Rubella. It includes hospitalisation expenses, OPD treatments, diagnostic tests, medication, etc. If you have congenital rubella syndrome, most mediclaim policies can cover the baby's treatment cost. However, coverage inclusions and exclusions vary by policy and insurer.

However, very few medical insurance plans cover the cost of the MMR vaccine (price varies between ₹150 and ₹1,200 depending on brand and the type of hospital where you receive it), which is a preventive measure for rubella. This is because basic health insurance plans usually do not cover vaccinations. Therefore, review the policy details carefully to understand the terms and conditions, and choose according to your health needs.

How Much Health Insurance Coverage is Needed for Rubella Treatment?

Health insurance plans cover the costs associated with the diagnosis and treatment of congenital diseases, including pre & post-hospitalisation, surgeries, and in-patient hospital stays. The recommended coverage amount for rubella and its related diseases usually ranges from ₹5 to ₹10 lakh.

However, coverage details can vary by insurance company and specific health plan. You may have to serve a waiting period of up to 3 years if the disease was diagnosed before purchasing the policy.