German measles, also known as Rubella and Three day measles, is a viral disease distinguished by a low-grade fever, rash and swollen glands. Most cases are mild and it often passes unnoticed, both of which can make diagnosis difficult. Rubella will usually last from 1-5 days, with children recovering more quickly than adults, typically.

However, during pregnancy, German measles can cause a serious risk; the virus is also transmittable from a mother to her developing fetus through the bloodstream by the placenta. If the mother is infected within the first 20 weeks of pregnancy, the child has up to a 90% chance of being born with congenital rubella syndrome (CRS), which includes a range of birth defects, including deafness, small head size, hepatomegaly, mental retardation and malformations of the heart. The German measles virus has an incubation period of 2 to 3 weeks during which it becomes established.


Infection is spread by contact with nasal or throat secretions from those already infected, as well as by aerosol transmission, i.e., through the air. A person is usually contagious from 7 days before until 7 days after the typical rubella rash appears.

German Measles Symptoms

Up to 50% of those infected with rubella wont have any symptoms.

Symptoms include:

  • Fever, usually under 38 degrees Celsius (100.4 degrees Fahrenheit)

  • Flaking, dry skin

  • Conjunctivitis

  • Body aches

  • Swelling of the lymph glands (especially those in the back of the neck)

  • Cough

  • Runny nose

  • A rash that looks like small, fine pink spots, develops on the face and then spreads over the entire body from head to foot. This rash lasts about 3 days.

  • In around 20% of all cases, Forchheimer’s sign occurs, and is characterized by small, red papules on the area of the soft palate.

Joint aches are very common in adult patients. Adults and older children may also have a headache, weakness, runny nose, and red eyes. Adult women often develop pain and stiffness in their finger, wrist, and knee joints, which may last up to a month.

To make certain if you have German measles, confirmation is made at your doctors with a blood test. Other methods of diagnosis have been put forth, including throat-swabs.

How Common Is It?

Since the rubella vaccine was introduced in 1969, cases of German measles and CRS in the United States have remained low. Nevertheless, cases are reported in persons who were infected in countries that do not routinely provide rubella vaccination.

In unvaccinated populations, rubella is primarily a childhood disease. When children are well immunized, adolescent and adult infections become more evident. Since 1994, most rubella and CRS cases were associated with outbreaks among adults, and 75% of all rubella cases were among persons 15-44 years of age.

A rubella vaccine is available as a single preparation, but it is recommended that in most cases rubella vaccine be given as part of the MMR vaccine (protecting against measles, mumps, and rubella). MMR is recommended at 12-15 months (not earlier) and a second dose when the child is 4-6 years old (before kindergarten or 1st grade)

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_ This article is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have this infection, consult a health care provider._

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