Rubella is also known as "German Measles" and is caused by rubella virus.
People usually present with a diffuse rash, fever, headache, malaise, enlargement of lymph nodes, upper respiratory symptoms and conjunctivitis. The rash usually lasts for about 3 days, but some patients may not have rash at all. Arthralgia or arthritis occurs more commonly in adult women with rubella.
Rubella infection can cause abnormalities in the developing foetus. Congenital rubella syndrome, characterised by deafness, cataract, heart malformations, mental retardation etc., is likely to occur in infants born to women who got infected during the first 3 months of pregnancy. Therefore, women of childbearing age who are not immunised should check their immune status before planning for pregnancy and receive rubella-containing vaccine if necessary.
It can be transmitted by contact with secretions from nose and throat of infected persons through droplet spread or direct contact with patients. This is a highly infectious disease and the patient can pass the disease to other persons from 1 week before to 1 week after onset of rash.
To prevent getting rubella, members of the public are advised to observe the following:
Affected persons should stay at home for 7 days from the appearance of rash and avoid contact with any susceptible persons, particularly pregnant women and women preparing for pregnancy. This is because pregnant women who do not have the immunity to rubella would contract the disease and their foetus could also be affected.
Immunisation against rubella is the most effective way to prevent the disease. People are advised to review their vaccination history and past medical history. People who had received rubella-containing vaccine documented by vaccination record, past history of laboratory confirmed rubella infection or positive blood test for rubella antibody are considered to be immune against rubella. Otherwise, they can be considered as non-immune to rubella.
For those without rubella vaccination, with unknown vaccination history or unknown immunity against rubella, they are advised to consult their doctor for advice on vaccination, which is usually given together with measles and mumps vaccines as Measles, Mumps and Rubella (MMR) vaccine. As it takes about two weeks after vaccination for antibodies to develop and provide protection against rubella, non-immune travellers are advised to plan and get vaccinated ahead (except pregnant women and women preparing for pregnancy).
As rubella-containing vaccine is contraindicated in pregnant women, all pregnant women and women preparing for pregnancy who are non-immune to rubella should not travel to areas with recent rubella outbreak. For outbreak news of the affected areas, please refer to the website of Department of Health's Travel Health Service.
Most (≥95%) people can enjoy long-term, or even lifelong protection after receiving a single dose of rubella-containing vaccine. In Hong Kong, children receive a two-dose course of rubella vaccination under the Hong Kong Childhood Immunisation Programme.
Local children aged under one year are not due for Measles, Mumps and Rubella (MMR) vaccine under the Hong Kong Childhood Immunisation Programme. As they are susceptible to rubella, they are advised not to travel to areas with recent rubella outbreak. If people must travel to these areas with children under one year during the outbreak period, they have to consult their doctor for advice. For outbreak news of the affected areas, please refer to the website of Department of Health's Travel Health Service.
Pregnant women and women preparing for pregnancy should consult their doctor for advice if they are not sure whether they are immune to rubella. As rubella-containing vaccine is contraindicated in pregnant women, all pregnant women and women preparing for pregnancy who are non-immune to rubella should not travel to areas with recent rubella outbreak. For outbreak news of the affected areas, please refer to the website of Department of Health's Travel Health Service.
If travellers upon returning from affected areas develop symptoms of rubella (e.g. fever and rash), they should seek medical advice immediately and avoid contact with non-immune persons, especially pregnant women, women preparing for pregnancy and infants. They should also report their symptoms and travel history in advance to the healthcare workers so that appropriate infection control measures can be implemented at the healthcare facilities to prevent any potential spread. For outbreak news of the affected areas, please refer to the website of Department of Health's Travel Health Service.
All foreign domestic helpers who are non-immune* to rubella should receive Measles, Mumps and Rubella (MMR) vaccine, preferably before they arrive in Hong Kong. If this is not possible, they can consult a doctor after they have arrived in Hong Kong. Employment agencies can consider adding the assessment of immune status against rubella or MMR vaccination for foreign domestic helpers as additional items in the pre-employment medical check-up package.
*In general, people can be considered as non-immune to rubella if (i) they did not have rubella infection confirmed by laboratory test before, and (ii) they had not been vaccinated against rubella or have unknown vaccination status.
For details about rubella-containing vaccines provided by the Government, please refer to infographic Learn more about rubella vaccine.
In general, the following individuals should NOT receive MMR vaccine^*:
^Medical advice should always be sought.
*According to information from the World Health Organization and the United States Centers for Disease Control and Prevention, anaphylactic reactions to MMR vaccines are not associated with hypersensitivity to egg antigens but to other components of the vaccines (such as gelatin). The risk for serious allergic reactions following receipt of these vaccines by egg-allergic persons is extremely low. Therefore, individuals with non-anaphylactic egg allergy can be safely vaccinated with MMR vaccine. Those with severe allergic reaction (e.g. anaphylaxis) to eggs should consult a healthcare professional for vaccination in an appropriate setting.
#In general, women should avoid pregnancy for three months after receipt of MMR vaccine and take appropriate contraceptive measure.