Health Centres - German measles (rubella)
What is German measles?
German measles (rubella) is an illness caused by a virus. Epidemics tend to break out every three to four years, although the illness is less contagious than measles and chickenpox.
While most children have measles in their early childhood, a lot do not get German measles until they are quite a bit older: 10 to 20 per cent of 20 to 25-year-olds have never had the disease. In fact, a lot of people have German measles in such a mild form that it is never diagnosed.
Today, only very few children get German measles, as most of them are vaccinated (MMR vaccine).
How do you get German measles?
German measles has a 'droplet spread'. That is, microscopic drops from the breath of an infected person are carried through the air to a healthy person. The droplets carrying the virus reach the mouth, throat and nose, from where they spread to the rest of the body.
What are the signs of German measles?
- The patient develops a rash. This typically starts around the ears from where it spreads all over the body in tiny pink spots. The rash changes almost from hour to hour, and will disappear again after about two to three days, requiring no treatment.
- Before the rash appears, the patient can suffer a light cold and/or swelling in the neck and base of the skull (due to the enlargement of the lymph nodes).
- The period between the time of infection and the actual outbreak of German measles (the incubation period) is usually quite long - between two and three weeks.
How is German measles treated?
German measles does not require any special treatment - except perhaps for a few days' rest in bed. However, you will have to consider the fact that the disease is infectious, and can easily spread to other members of the household.
The infection period usually lasts from a week before the rash starts to one week after it has disappeared, but is at its worst when the rash is at its peak. Because of the risks to pregnant women associated with the disease (see below), it is an advantage for girls to acquire immunity before puberty.
What risks are associated with German measles?
If a pregnant woman is infected with German measles there is a risk of damage to the unborn child. In some cases, the dangers are so high that an abortion is recommended. Fortunately, this is very rare today as most young women have been vaccinated against German measles.
Who should be vaccinated?
It is impossible to know for sure if you have had German measles because many people do not even notice the disease. Girls who are vaccinated against German measles are advised not to start a pregnancy until three months after the vaccination.
If you are in any doubt as to whether or not you have had the illness, an examination of antibodies in the blood will provide the answer. If required, your doctor can give you a vaccination.
All girls should be vaccinated against German measles to prevent problems during an eventual pregnancy. Today, all children between 12 and 15 months are offered the measles, mumps and rubella vaccine (MMR II
or Priorix)
which protects them from rubella. 
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