Rubella virus (family Togaviridae, genus Rubivirus).
Person-to-person contact or droplets shed from the respiratory secretions of infected people. Transmission from mother to fetus can also occur, resulting in an infant being born with congenital rubella syndrome.
Occurs worldwide outside the Americas. In the United States, endemic rubella virus transmission has been eliminated, but it continues to be imported.
Average incubation period is 14 days (range, 12–23 days). Usually presents as a nonspecific, maculopapular, generalized rash that lasts ≤3 days with generalized lymphadenopathy. Rash may be preceded by low-grade fever, malaise, anorexia, mild conjunctivitis, runny nose, and sore throat. Asymptomatic rubella virus infections are common. Infection during early pregnancy can lead to miscarriage, fetal death, or severe birth defects known as congenital rubella syndrome.
Demonstration of specific IgM or significant increase in IgG in acute- and convalescent-phase specimens. RT-PCR can be used to detect virus; viral culture is also acceptable but is time-consuming and expensive.
All travelers age ≥12 months should have evidence of immunity to rubella, as documented by ≥1 dose of rubella-containing vaccine on or after the first birthday, laboratory evidence of rubella immunity, laboratory confirmation of disease, or birth before 1957 (except women who could become pregnant).
CDC. Rubella. In: Atkinson W, Wolfe S, Hamborsky J, editors. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation; 2012. p. 275–89.
Reef SE, Plotkin SA. Rubella vaccine. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 6th ed. Philadelphia: Saunders Elsevier; 2012. p. 688–717.
Reef SE, Redd SB, Abernathy E, Kutty PK, Icenogle JP. Evidence used to support the achievement and maintenance of elimination of rubella and congenital rubella syndrome in the United States. J Infect Dis. 2011 Sep 1;204(Suppl 2):S593–7.
McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS. Prevention of measles, rubella, congenital rubella syndrome, and mumps 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013 Jun 14;62(RR-4):1–34.