What is Rubella? Its definition, symptoms, treatment, vaccination, and advice during pregnancy.


English 風疹

Rubella (or German Measles) is an infectious disease caused by the rubella virus.

This highly contagious virus can spread through close contact or through the air. It may pass from person to person through contact with tiny droplets or fluid from the nose and throat when sneezing and coughing. Usually, symptoms are fever or red rash. However, in some cases, it's asymptomatic and it can be transmitted without notice. The most important point is the transmission by a pregnant woman to her fetus through the bloodstream. This is a very serious health concern.

Rubella main symptoms are fever and red rash.


While rubella is thought to be a child disease, 90 % of the outbreak concerns adults in Japan. In 2013, a widespread contagion made more than 14000 people infected. One of the main symptoms is a red rash appearing all over the body.
Other symptoms are:

  • Mild fever (± 38 degrees Celsius)
  • Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears.
  • Inflamed, red eyes
  • Light cough

All those symptoms do not occur necessarily. In adults, you may have joint pain. Adults could also get high fever, as well as long lasting symptoms like rash. Illness could also be more severe in adults.

When rubella infection occurs during pregnancy, serious consequences could affect infants.


The most serious case is an infection during pregnancy. If the infection occurs up to 20 weeks of pregnancy, it could infect the fetus and it may cause a baby to be born with Congenital Rubella syndrome (CRS). Having rubella during early pregnancy increases the risk of disabilities.
When the fetus has CRS, it may cause birth defects such as:

  • Deafness
  • Heart problems
  • Vision problems like cataract, glaucoma, retinopathy
  • Low birth weight
  • Intellect, motor development disabilities
  • Growth retardation
  • Thrombopenic purpura
  • Splenohepatomegalia

As rubella could have a very serious consequence in early pregnancy, it is necessary to vaccinate everybody including men.

Transmission of the rubella virus is often from men to women!

The most important point is the infection during pregnancy.
The baby could be affected and have the Congenital Rubella Syndrome. To avoid this, everyone should get a Rubella vaccination.

Rubella virus is extremely contagious

Rubella (German Measles) is extremely contagious and it is transmitted by the rubella virus. Rubella spreads through respiratory droplets. It's a droplet infection and can also be transmitted by contact. Virus can spread with a cough or sneeze or just by talking and breathing. (droplets can spread from to 1 to 2 meters)


When you contract Rubella, symptoms appear after an average incubation period of 16-18 days.
However, 15-30% of persons contracting the virus are asymptomatic. We call it a subclinical infection. These infected persons are thus asymptomatic carriers of the virus.
During the 2013 epidemic, men were three more times infected than women. The common place of infection was often at the workplace. The transmission of the virus is very important between couples. And when this happens during pregnancy, the baby could contract congenital rubella syndrome. To avoid CRS, it's important to vaccinate everyone.

Rubella can be avoided by vaccination

This vaccination is usually given in the hospital or at a pediatrician. One person out of twenty won't get antibodies with a single vaccination, it is therefore recommended to receive 2 vaccinations. The second vaccination must be received more than a month later than the first one. We recommend a combined Measles-Rubella Vaccine.

Vaccination while being pregnant is not recommended. For a woman who plans to get pregnant and already had the rubella vaccine during childhood, it is necessary to get 2 doses of vaccine. It's recommended not to become pregnant for 2 months after having received the vaccine.

Where to get the vaccine?

The vaccination can be done at the hospital or at a pediatrician. Make sure that they have vaccine available. If the vaccine is for a one-year old child or a child before entering primary school, the municipality will bear the cost of vaccination. However, not all municipalities help with the financial costs of vaccination.

Persons having doubts can also get a screening for immunity to rubella.

If you have any doubts of having immunity to rubella, you can do a blood test in a medical institution. This immunity check is not covered by the health insurance. However, some municipalities might help with financial aspects.

The system of rubella vaccination differs with age

There are lots of people who did not get a rubella vaccination. This is due to changes in the system of regular vaccination. It depends on the individual's birthdate. For people who went to school in Japan

  • no inoculation for people born before 1st April 1962
  • born between 2nd April 1962~1st April 1975: no inoculation for boys, 1 inoculation for girls during Junior High School period.
  • born between 2nd April 1979-1st October 1987: for boys and girls, 1 inoculation during Junior High School period.
  • born between 2nd October 1987-1st April 1990: for boys and girls, 1 inoculation while being a baby
  • born after 2nd April: 2 inoculations for boys and girls (the inoculation period depends on the birthdate)

We recommend to all the following categories of people to receive the rubella vaccine for their families and themselves.

  • Those who didn't have any occasion to get rubella vaccination
  • Those who don't remember
  • Those who don't know if they have been exposed to rubella virus.