Rubella is a contagious disease that is caused by a virus. It is also known as “German measles”. The disease is usually mild, and the symptoms include a low fever and a rash. But, if a pregnant individual gets rubella, the virus can cause serious birth defects.

How rubella is spread

Rubella spreads through the air when an infected person coughs or sneezes. People can catch it by:

  • breathing the air where an infected person has coughed and/or sneezed
  • touching objects contaminated with the virus
  • sharing food or drinks, or kissing someone who has the virus

Rubella is most contagious when the infected person has a rash. However, it can still be spread up to 7 days before and 4 days after a rash appears. About half of the people who get rubella do not have symptoms. People without symptoms can still spread rubella.

Risks of rubella

Most people who get rubella usually have a mild case. However, in rare cases, rubella can cause serious problems, including:

  • internal bleeding
  • swelling of the brain (encephalitis)
  • a viral infection of the brain, which can lead to diseases of the nervous system

Rubella is very dangerous for pregnant individuals and unborn babies. If an unvaccinated pregnant person gets rubella, they may have a miscarriage or stillbirth. They may also pass the virus to their unborn baby. Infection affects all organs of the fetus and can cause a condition called congenital rubella syndrome (CRS). This is a serious disease that can lead to:

  • damage to the heart, the liver and/or the spleen (the spleen is an organ in the body that helps filter blood)
  • loss of hearing and/or eyesight
  • intellectual disability (mental delay)

Serious birth defects are more common if a person is infected early in their pregnancy, especially in the first trimester. There is no treatment for congenital rubella syndrome. Rubella can be prevented through immunization.

Rubella was once a common childhood disease. Thanks to routine immunization, rubella has been eliminated in Canada so the risk of getting rubella here is very low. However, rubella still happens around the world and it is very contagious. Travellers who are not vaccinated may catch or bring rubella into Canada. As a result, cases or outbreaks may occur, especially in communities where people are not vaccinated.

A pregnant person and their unborn baby have the highest risk of serious complications if they become infected with rubella. If you or your children have not been vaccinated and have never had rubella, you are at risk of infection.


Some people who are infected with rubella will not show any symptoms. People who do have symptoms usually get them between 2 and 3 weeks after being exposed to the virus. In younger children, symptoms include:

  • a rash that starts on the face and spreads to the rest of the body; the rash lasts about 3 days
  • a low fever (less than 39°C)
  • nausea
  • conjunctivitis (an eye infection, often called “pinkeye”)

In older children and adults, symptoms can also include:

  • swollen salivary glands (the salivary glands are located in your cheeks, near your jaw and below each ear)
  • cold-like symptoms, before the rash appears
  • aching joints

Protection and prevention

You can protect against rubella with a safe and effective vaccine. In Ontario, children receive two doses of rubella vaccine. The vaccine is given at:

  • 1 year of age
  • 4 to 6 years of age

Children should be vaccinated on schedule to protect them from getting rubella, and to stop them from spreading it to a pregnant person and their unborn baby.

The vaccines are part of the publicly funded vaccine schedule and are offered free to all people in Ontario. The rubella vaccine is required for children to attend school in Ontario and for children attending a daycare centre unless they have a valid exemption.

Vaccination is also publicly funded for adults if they have never had rubella or been vaccinated. Anyone who is not protected is at risk of getting rubella.

Rubella is still very common in many parts of the world, including Africa, the Eastern Mediterranean and Southeast Asia. Talk to your health care provider before you travel. For more information on global outbreaks of rubella, please visit the Government of Canada website.

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