Rubella

Rubella (also known as German measles) is a generally benign infectious disease with rash, which can occur in children and adults alike. However, in pregnant women, the disease can have serious consequences for the fetus. The disease can be avoided by vaccination.

What is rubella?

Rubella is an infectious disease caused by the Rubivirus. This virus is transmitted from person to person by droplets from the nose, mouth and throat.

Symptoms

Rubella is generally benign and manifests itself in the form of fever, malaise, lymphadenopathy and general rash of the skin. Adults, mainly women, may also suffer from arthritis and painful joints for 3-10 days.

Infectivity

Rubella is a contagious infectious disease that is transmitted from one person to another through contact with nasal, throat or mouth secretions. Rubella is contagious from 7 days before to 7 days after the onset of the rash, with maximum infectivity during the catarrhal phase (phase of malaise prior to the appearance of the rash) and 1 to 5 days after the skin rash has become visible.

Complications

In pregnant women, rubella can have serious consequences for the fetus. The fetus may be infected with the virus during pregnancy. This creates an increased risk of miscarriage, stillbirth or the birth of a child with congenital rubella syndrome (CRS). Children with CRS can have a wide range of abnormalities: heart disease, cataract, deafness, retardation and malformations.

Diagnosis

A diagnosis of rubella is first made based on clinical symptoms and then confirmed by laboratory tests (serum and/or nose and throat swab).

There is also prenatal screening, in which “healthy women” without clinical symptoms are tested for the presence of sufficient protective antibodies in the blood. Determination of the protective antibodies titer (IgG) is sufficient for this purpose. Determination of specific antibodies against rubella (IgM) is only necessary in persons with clinical signs and suspected rubella symptoms.

Treatment

There is no specific treatment for rubella. The disease can be prevented by vaccination.

Vaccination

The vaccination schedule provides for two doses, one at the age of 12 months and one at the age of 10-12 years. These vaccines are part of the basic vaccination scheme for children and adolescents and are offered free of charge through government vaccination programs.

It is important to note that there is strict monitoring of the quality of all vaccines on the market in Europe. Only after a European Official Medicines Control Laboratory (OMCL) has checked the quality of a vaccine can it be placed on the market. This control consists on the one hand of a critical review of the production data and quality analyses carried out by the vaccine manufacturer and on the other hand of additional analyses carried out by an OMCL. This control is one of Sciensano’s responsibilities.

Occurrence

Rubella occurs mainly in winter and spring, but can occur throughout the year.

Risk groups

All non-vaccinated persons constitute a possible risk group. In particular, children under 1 year of age, pregnant women, persons with immunosuppressive disorders and staff in the care sector. In pregnant women, rubella can have serious consequences for the fetus (see complications).

Compulsory notification

Because of the public health risks, rubella is a compulsorily notifiable infectious disease in Brussels and congenital rubella syndrome (CRS) is notifiable in Wallonia.

Information for health professionals

Detailed information on the disease can be found in the guidelines of the Flemish Community and the guidelines of the French Community.

Sciensano is primarily active as a National Reference Center for the confirmation of rubella. Sciensano collects data on the occurrence of congenital rubella and is responsible for monitoring the elimination status of rubella in Belgium according to WHO guidelines. The Belgian Official Medicines Control Laboratory (OMCL) of Sciensano, together with the European OMCL network, is responsible for the quality control of the Measles-Mumps-Rubella (MMR) and Measles-Mumps-Rubella-Varicella (MMRV) vaccines prior to...

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