From the Guidelines

Rubella, also known as German measles, is a viral infection that can cause mild to severe symptoms.

It is an exanthematous illness characterized by nonspecific signs and symptoms including transient erythematous and sometimes pruritic rash, postauricular or suboccipital lymphadenopathy, arthralgia, and low-grade fever 1.
The incubation period ranges from 12 to 23 days 1.
25%-50% of rubella infections are subclinical 1.

To prevent rubella, vaccination is recommended. The measles, mumps, and rubella (MMR) vaccine is typically administered in two doses, with the first dose given at 12-15 months of age and the second dose at 4-6 years of age.
For non-pregnant adults who have not been vaccinated, a single dose of MMR vaccine is recommended.
Post-exposure prophylaxis can be achieved with the MMR vaccine administered within 72 hours of exposure. In addition, immunoglobulin can be given to high-risk individuals, such as pregnant women, within 72 hours of exposure.
There is no specific antiviral medication available for the treatment of rubella. However, symptoms can be managed with over-the-counter medications such as acetaminophen or ibuprofen to reduce fever and alleviate discomfort.

Pregnant women who contract rubella during the first 20 weeks of pregnancy are at risk of miscarriage, stillbirth, or birth defects 1. Therefore, it is essential for pregnant women to be vaccinated before becoming pregnant, if possible. If a pregnant woman is exposed to rubella, she should consult her healthcare provider immediately.
The MMR vaccine has an excellent safety profile, with the most common adverse reactions being transient rashes, lymphadenopathy, fever, sore throat, and headache 1.

From the Research

Rubella, also known as German measles, is a pleomorphic RNA virus in the Togaviridae family of the genus Rubivirus 2.
It typically causes a scarletiniform rash, cervical lymphadenopathy, and mild constitutional symptoms, but can be more severe in older children and adults, especially women, with joint involvement and purpuric rash 2.
Rubella is usually a mild and self-limited disease in children, but can have potentially devastating effects on the developing fetus during pregnancy 3.

The virus is spread via oral droplets and is shed in the nasopharynx for approximately 7 days before and after the rash is visible 2.
Humans are the only natural reservoir for the rubella virus, and it is present in nasopharyngeal secretions, blood, feces, and urine during the clinical illness 2.
Patients with subclinical disease are also infectious 2.

Infection during the first 12 weeks of pregnancy results in congenital infection and/or miscarriage in 80-90% of cases 2.
CRS involves multiple organ systems and has a long period of active infection and virus shedding in the postnatal period 2.
The classic triad of CRS includes cataracts, congenital heart defects, and sensorineural deafness, which typically occur if the fetal infection occurs in the first 11 weeks of gestation 3.
Other complications of CRS include nerve deafness, cardiac anomalies, mental retardation, diabetes, thyroid disease, growth hormone deficiency, and progressive panencephalitis 2.

The rubella vaccine program was instituted in 1969, and the incidence of rubella infection in the United States has since declined by 99% 2.
Universal childhood immunization and vaccination of all susceptible patients with rubella vaccine are cornerstones to prevention of rubella and CRS 3.
Treatment is mainly symptomatic, and a specific (antiviral) therapy is not available 4.
Laboratory confirmation of rubella virus infection can be based on a positive serological test for rubella-specific immunoglobulin M antibody, a four-fold or greater increase in rubella-specific immunoglobulin G titres, or detection of rubella virus RNA by reverse transcriptase-polymerase chain reaction 3.