Rubella

Rubella is a vaccine preventable disease that can affect both children and adults, and like measles often occurs in epidemics. In New Zealand rubella is uncommon, due to effective vaccine coverage.

Occasional cases of rubella infection in pregnancy and congenital rubella syndrome continue to occur in New Zealand. A cohort of women born in the years 1965 to 1967 (ie, aged 31–33 years in 1998) may be less likely to have been immunised as children than women born before or later.

Maternal rubella in the first eight weeks of pregnancy results in foetal damage in up to 85 percent of infants and multiple defects are common. The risk of damage declines to 10–20 percent by about 16 weeks’ gestation, and after this stage of pregnancy foetal abnormalities are rare. Infants born with the congenital rubella syndrome (CRS) may have cataracts, nerve deafness, cardiac malformations, microcephaly, mental retardation and behavioural problems. Inflammatory changes may also be found in the liver, lungs and bone marrow. Some infected infants may appear normal at birth, but have nerve deafness detected later.

All cases of clinically suspected or lab confirmed rubella and CRS should be notified to the local public health medicine specialist.

How does a person become infected?

Transmission is primarily via respiratory secretions. Infants with CRS shed rubella virus in their respiratory secretions and urine. Rubella can be transmitted from a person for one week before and at least four days after the onset of the rash. Infants with CRS may shed virus for months after birth.

Signs and symptoms of the illness

Rash, swollen neck glands, sore joints, feeling unwell or no symptoms at all. In adults, arthritis or arthralgia may occur. Rubella may present as a more severe illness, clinically indistinguishable from measles. Encephalitis occurs more frequently than the previously estimated 1 in 6000 cases and may result in residual neurological damage or occasionally death. Thrombocytopaenia rarely occurs.

Treatment of rubella

Parents/caregivers are advised that children with rubella should be excluded from early childhood services or school for seven days from the appearance of the rash. Children with CRS should be considered infectious until they are one year of age.

Adults with rubella should be excluded from institutions or work until fully recovered or for seven days after onset of rash. Contact with women of childbearing age should be avoided if possible.

Unimmunised contacts may have to be excluded from early childhood services, or schools after consultation with the Public Health Unit.

Pregnant women known to be susceptible to rubella must avoid contact with known or suspected cases.

Current control measures include antenatal screening and vaccination of susceptible women after delivery and a two-dose MMR immunisation schedule at ages 15 months and 4 years.

More information

For more information about Rubella, please contact your doctor or a health protection officer from the Health Protection Unit.

back to Communicable disease list

back to top