Clinical Information

Rubella (German or 3-day measles) is a member of the Togavirus family and humans remain the only natural host for this virus. Transmission is typically through inhalation of infectious aerosolized respiratory droplets and the incubation period following exposure can range from 12 to 23 days.(1) Infection is generally mild, self-limited, and characterized by a maculopapular rash beginning on the face and spreading to the trunk and extremities, fever, malaise, and lymphadenopathy.(2)

Primary in utero rubella infections can lead to severe sequelae for the fetus, particularly if infection occurs within the first 4 months of gestation. Congenital rubella syndrome is often associated with hearing loss and cardiovascular, and ocular defects.(3)

The United States 2-dose measles, mumps, rubella  vaccination program, which calls for vaccination of all children, leads to seroconversion in 95% of children following the first dose.(1) A total of 4 cases of rubella were reported to the Centers for Disease Control and Prevention in 2011 without any cases of congenital rubella syndrome.(4) Due to the success of the national vaccination program, rubella is no longer considered endemic in the United States (www.cdc.gov/rubella). However, immunity may wane with age as approximately 80% to 90% of adults will show serologic evidence of immunity to rubella.