Rubella, also called German measles or three-day measles, is a very contagious disease caused by the rubella virus. The virus causes fever, swollen lymph nodes behind the ears, and a rash that starts on the face and spreads to the torso and then to the arms and legs. Rubella is no longer very common because most children are immunized beginning at 12 months of age. Rubella is not usually a serious disease in children, but can be very serious if a pregnant woman becomes infected. Infection with rubella in the first 3 months of pregnancy can cause serious injury to the fetus, resulting in heart damage, blindness, deafness, mental retardation, miscarriage, or stillbirth.

Rubella is spread person-to-person by breathing in droplets of respiratory secretions exhaled by an infected person. It may also be spread when someone touches his or her nose or mouth after their hands have been in contact with infected secretions (such as saliva) of an infected person. A person can spread the disease from as many as 5 days before the rash appears to 5 to 7 days after.

Rubella may be prevented by immunization. The rubella vaccine is part of the MMR (measles, mumps, rubella) vaccine series administered to children beginning at 12 months of age.

All childcare providers should be immune to rubella. People are considered immune only if they have received at least one dose of Rubella vaccine on or after their first birthday or if they have laboratory evidence of rubella immunity.

If a child or adult in the child care facility develops rubella:
Exclude the infected child or adult until 6 days after the onset of the rash.
Notify the local health department immediately.

Review all immunization records of the children in your care. Any children under 12 months who have not yet been vaccinated against rubella should be excluded until they have been immunized or until 3 weeks after the onset of rash in the last case.

Refer any pregnant woman who has been exposed to rubella to her doctor.
Follow good hand washing and hygiene procedures.
Carefully observe other children, staff, or family members for symptoms.

© January 1997