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Division of Public Health Services Disease Handbook for Childcare Providers
Bureau of Infectious Disease Control REVISED –January 2018
RUBELLA (GERMAN MEASLES)
Rubella is a childhood viral disease, which causes
a rash, low -grade fever and swollen glands in the
area behind the ears. Some children may have a
very mild illness with no rash at all. However, if
a pregnant woman without pr otection against
rubella is exposed to the disease, there could be
harmful effects to her baby. Pregnant women
should consult their physician at once if they
have been exposed to rubella!
Who gets this disease?
Some young adults remain susceptible to rubella
due to high school graduation prior to the school
rubella vaccination laws. Rubella is most often
seen in unimmunized children and in this
susceptible adolescent and young adult group.
How is it spread?
The virus is spread by large droplets spread
through the air from sneezing or coughing, or by
direct contact with infected nasal or saliva
secretions.
What are the symptoms?
1. A two to three day rash that begins on the
face and quickly spreads downward over
the entire body.
2. A low- grade fever of 101- degrees
Fahrenheit or less.
3. Swollen glands behind the ears. (NOTE:
this may appear before the rash). Joint and
body pain is most commonly experienced
in adults.
4. Symptoms appear 12 -23 days after
exposure; usually 16-18.
Infected persons are contagious from one week
before to 5-7 days after the appearance of the
rash. A small percentage of properly immunized
children may be infected with rubella due to
occasional vaccine failure.
How can the spread of this disease be
prevented?
The national Advisory Committee on
Immunization Practices (ACIP) recommends that
children be immunized against rubella after 12-
months of age. The two dose vaccine should be
completed at 12 -15 months of age and 4- 6 years.
This immunization is required for both childcare
and school atte ndance. The vaccine is usually
combined with measles and mumps vaccine.
Who should be excluded?
A child or staff member with rubella or suspect
rubella should not return to daycare until seven
days after the onset of the rash.
Reportable?
Yes. Rubella is reportable immediately by New
Hampshire law to the Division of Public Health
Services, Bureau of Infectious Disease Control at
(603) 271-4496.