Rubella, or German measles, is an infectious disease that is caused by the rubella virus. Since the introduction of the measles, mumps, and rubella (MMR) vaccine, it is a relatively rare condition. Rubella is transmitted via airborne droplets and has a mild clinical course. The clinical presentation begins with nonspecific flu-like symptoms and post-auricular and/or suboccipital lymphadenopathy. An exanthem phase may overlap or follow; this phase is characterized by a rash that typically starts behind the ears and progresses distally, developing into a generalized maculopapular rash. Rubella is usually self-limiting and involves symptomatic treatment. Complications of infection during pregnancy may cause congenital rubella syndrome with severe malformations (e.g., hearing loss, cataracts, heart defects, intellectual disabilities). The rubella vaccine is a combination vaccine that protects against measles, mumps, and rubella (MMR vaccine); the MMRV vaccine also protects against varicella. Immunization is recommended for all children, in addition to adults without evidence of immunity to measles, mumps, and/or rubella.
- Route of transmission
Patients with rubella infection are asymptomatic in ∼ 50% of cases. Young children have a far milder course than older children and adults; the latter group often presents with prodromal symptoms, other systemic complaints (e.g., arthritis), and a longer duration of infection.
- Incubation period: 2–3 weeks after infection
- Duration: 1–5 days
- Duration: lasts 2–3 days
Although rubella infection may be considered a clinical diagnosis; , laboratory confirmation is necessary for certain patient groups to assess the risk of complications such as e.g., congenital rubella in pregnant women or encephalitis.
The differential diagnoses listed here are not exhaustive.
- Symptomatic treatment
- For treatment of congenital rubella syndrome and seronegative women following exposure to rubella virus, see “ .”
Isolate patients with confirmed infection. 
- All individuals: Isolate for 7 days from the onset of rash.
- Hospitalized patients: Initiate .
Rubella is a nationally notifiable disease; report all cases to the appropriate health departments. 
Evidence of immunity to rubella 
- See “ ” and “ .”
- If laboratory evidence of immunity to rubella is required, perform serologic testing. 
Exposure control 
For confirmed cases of rubella:
- Patients: Isolate for 7 days from the onset of rash to prevent further transmission .
- Exposed contacts without Quarantine for 23 days from the onset of rash in the last known exposure.  :
Women of reproductive age without should be vaccinated prior to pregnancy to prevent .