Superdrug Health

Immune system

Rubella (sometimes called German measles) is a mild disease but can, in about 1 in 6000 cases, lead to encephalitis (inflammation of the brain). However, rubella is particularly dangerous if contracted during the first 8 to 10 weeks of pregnancy, causing damage to the unborn baby (called congenital rubella syndrome) resulting in death or blindness, deafness, heart, brain, liver and lung damage.

The policy to immunise all children in the UK against rubella has, since the introduction of the immunisation policy in 1988, produced a dramatic fall in the number of cases of rubella. This has had a significant effect in protecting adult women from exposure to the disease and, as a result, cases of congenital rubella syndrome are now rare in UK-born women.

Rubella is caused by a virus. It is spread through droplets from coughing and sneezing by someone infected with the virus. The incubation period, that is the time taken for the disease to develop after being infected with the virus, is about 14 to 21 days. Individuals are infectious from one week before symptoms first appear to four days after the appearance of the rash.

The symptoms of rubella start like a bad cold with a high temperature, cough, sore eyes and runny nose. A red rash appears most usually behind the ears, on the face and neck, but only lasts for a short time and may easily go unnoticed. Glands may swell before the appearance of the rash.

Medicines

In the UK, most children are routinely vaccinated against rubella with a vaccine known as MMR which also protects against mumps and measles. Children are given the vaccine between 12 and 18 months of age and then given a booster between 4 and 5 years. Infants under 12 months of age travelling to countries where rubella is still a problem should also be vaccinated with MMR. As the vaccine is less effective when given early, these children will need two further doses of the vaccine at the recommended ages to ensure that they are adequately protected. There is no evidence that MMR vaccination harms an unborn baby. However, as a precaution, MMR vaccine should not be given to women who are pregnant and if given to a non-pregnant woman, adequate contraceptive measures must be used for at least a month.

It is common for children to develop a mild fever and rash after the immunisation and generally feel a bit grizzly. The recommended dose of paracetamol is advised if the child develops a temperature.

There has been much publicity about giving a single vaccine for each disease separately, rather than giving the combined triple vaccine (MMR) to protect against all three diseases, through the misunderstanding that MMR may cause bowel disease or autism. The conclusion of experts from all over the world, including the World Health Organization, is that there is no link between MMR vaccines and bowel disease or autism. The World Health Organization advises against using separate vaccines for the simple reason that doing so would leave children at risk and offer no benefits. No country in the world recommends giving MMR as three separate vaccines. Giving the vaccines separately may be harmful because it leaves children open to the risk of catching measles, mumps or rubella. By having them all at once, your child is protected against all three diseases as soon as they have had the MMR injection.

You can obtain paracetamol from your local pharmacy without the need for a prescription to help reduce your child’s temperature following immunisation. Always check the label of medicines to make sure that you are not giving your child too much paracetamol. Aspirin should not be used in children under 16 years of age to lower high temperatures or for pain relief.

If you think you or your child has the symptoms of rubella you should consult your doctor. After MMR vaccination, your child may feel grizzly but if crying is prolonged or there is a persistent rash or fever, you should see your doctor. Swelling might occur at the injection site but is not normally any larger than the surface area of a 10p coin, any larger swelling should be checked by your doctor.

If you are thinking of starting a family and you are not sure whether you have been immunised against rubella, see your doctor before you get pregnant.