Rubella: Treatment and Prevention

Rubella is usually a mild illness in children and adults, but infection during early pregnancy can cause congenital rubella syndrome (CRS). There is no specific antiviral therapy; care focuses on symptom relief, isolation to prevent spread, and vaccination to prevent future cases.

Quick Takeaways

• Most cases need only supportive care at home; avoid aspirin in children/teens due to Reye syndrome.
• Isolate until 7 days after rash onset; infants with CRS can shed virus for months and require extended precautions.
• Vaccination (MMR) prevents rubella and CRS; it’s contraindicated in pregnancy but should be given postpartum if non‑immune.

Home Care and Symptom Relief

• Rest and fluids; light, easily digestible meals.
• Antipyretics/analgesics: acetaminophen or ibuprofen as appropriate for age and health status.
• Comfort measures: cool compresses for fever, saline nasal spray or humidified air for congestion, oral care if mucosa is irritated.
• Avoid aspirin in children/adolescents because of the risk of Reye syndrome.

When to Seek Medical Care (Red Flags)

• Persistent high fever, severe headache, neck stiffness, confusion, seizures.
• Chest pain, shortness of breath, palpitations (possible myocarditis).
• Signs of bleeding/bruising (possible thrombocytopenia) or dehydration.
• Pregnancy or suspected pregnancy with exposure or symptoms — seek care urgently.

Special Considerations in Pregnancy

• MMR vaccine is contraindicated during pregnancy. Check rubella IgG to assess immunity after exposure.
• Non‑immune pregnant individuals with exposure require urgent obstetric and public‑health consultation. Immune globulin has uncertain benefit for preventing CRS and is not routinely recommended; individualized decisions may be made in select cases.
• Postpartum: vaccinate non‑immune persons before discharge and counsel to avoid pregnancy for a period after vaccination per local guidance.

Isolation and Infection Control

• Stay home and avoid close contact with others until 7 full days after rash onset.
• Use droplet precautions in clinical settings; notify healthcare facilities in advance if evaluation is needed.
• CRS infants: coordinate with public health for prolonged precautions due to extended viral shedding.

Prevention — Vaccination

• Vaccine: MMR (measles‑mumps‑rubella) provides reliable protection.
• Typical schedule: first dose at 12–15 months; second dose at 4–6 years. Follow local schedules, including catch‑up for unvaccinated children and adults.
• Ensure documented immunity for healthcare workers, students, and travelers.

After Exposure (PEP)

• MMR is not used as PEP in pregnancy and is contraindicated during pregnancy.
• Routine immune globulin to prevent rubella/CRS is not reliable; may be considered case‑by‑case for exposed, non‑immune pregnant people who choose to continue pregnancy — consult specialists and public health.

What Not to Do

• Antibiotics don’t treat rubella (a viral illness).
• No role for corticosteroids or antivirals in uncomplicated rubella.

Educational information only; follow local public health guidance and consult clinicians for individualized care.