Some people have no symptoms. But if they do, symptoms of rubella most often appear 2 to 3 weeks after being exposed to the virus. Symptoms last about 1 to 5 days and may include:

• Mild fever of 102 degrees Fahrenheit (38.9 degrees Celsius) or lower.
• Headache.
• Stuffy or runny nose.
• Red, itchy eyes.
• Enlarged, tender lymph nodes at the base of the skull, at the back of the neck and behind the ears.
• A fine rash that begins on the face. It can look pink or red on white skin. It might be harder to see on Black or brown skin. It quickly spreads to the belly and then to the arms and legs. It goes away in the same order.
• Aching joints, most often in adults assigned female at birth.

Contact your healthcare professional if you think you or your child may have been exposed to the virus that causes rubella or if you see symptoms of rubella.

If you're thinking about getting pregnant, check your vaccination record to make sure you've had your MMR vaccine. If you're pregnant and you get rubella, especially during the first trimester, the virus can cause death or serious birth defects in the growing fetus.

Rubella during pregnancy is the most common cause of deafness that's present at birth, called congenital. It's vital to be protected against rubella before pregnancy.

If you're pregnant, you'll likely be screened to see if you're immune to rubella. But if you've never had the vaccine and you think you might have been exposed to the virus that causes rubella, contact your healthcare professional right away. You can have a blood test to find out if you're immune.

Rubella is caused by a virus that's passed from person to person. It can spread when an infected person coughs or sneezes. It also can spread through direct contact with infected mucus from the nose and throat. And it can be passed from pregnant people to their unborn children.

A person who has been infected with the virus that causes rubella is contagious from about one week before the rash starts until about one week after the rash goes away. Infected people can spread the illness before they know they have it.

Rubella is rare in many countries because most children are vaccinated against the infection at an early age. In some parts of the world, the virus is still active. Keep this in mind before going abroad, especially if you're pregnant.

Once you've had the disease, you're likely to be immune for life.

Risk factors for getting rubella include:

• Not being vaccinated against rubella.
• Being in close contact with someone who has rubella.

Rubella is a mild infection. Some people assigned female at birth who have had rubella get arthritis in the fingers, wrists and knees. This most often lasts about a month. Rarely, rubella can cause swelling and irritation, called inflammation, of the brain.

If you're pregnant when you get rubella, the effect on your unborn child may be severe. It can cause you to have a miscarriage or a stillbirth. Congenital rubella syndrome occurs in up to 85% of infants born to people who had rubella during the first 12 weeks of pregnancy. This syndrome can cause one or more problems, including:

• Growth delays.
• Cataracts.
• Deafness.
• Problems with how the heart forms, called congenital heart defects.
• Problems with how other organs form.
• Problems with learning.

The highest risk to the fetus is during the first three months of pregnancy. But being exposed later in pregnancy also is dangerous.

The rubella vaccine most often is given as a combined measles-mumps-rubella vaccine, also called the MMR vaccine. A vaccine also may include the chickenpox vaccine, also called the varicella vaccine. It's called the MMRV vaccine.

Healthcare professionals suggest that children get the first MMR vaccine between 12 and 15 months of age. They get the second vaccine between 4 and 6 years of age, before they start grade school.

The MMR vaccine prevents rubella and protects against it for life. Getting the vaccine can prevent rubella during future pregnancies.

Babies born of people who have received the vaccine or who already are immune are most often protected from rubella for 6 to 8 months after birth. Some children might need the vaccine before 12 months of age for travel to certain countries or other reasons. They can get it as young as 6 months of age. But children who are vaccinated early still need to be vaccinated at the suggested ages later.

No proven link between the MMR vaccine and autism

Some people have been worried about a possible link between the MMR vaccine and autism. But studies from the American Academy of Pediatrics, the National Academy of Medicine, and the Centers for Disease Control and Prevention conclude that there is no proven link between the MMR vaccine and autism.

Do I need the MMR vaccine?

You don't need a vaccine if you:

• Had two doses of the MMR vaccine after 12 months of age.
• Have blood tests that show you're immune to measles, mumps and rubella.
• Were before 1957. People born before 1957 are likely to have had measles, mumps and rubella during childhood and so are immune. But if you don't have a blood test that shows you're immune, talk to your healthcare professional about getting the MMR vaccine.

You do need to get a vaccine if you have not had two doses of the MMR vaccine after age 12 months. Or if you haven't had blood test that shows you're immune to measles, mumps and rubella.

Being sure you're immune is crucial if you:

• Are of childbearing age and could become pregnant.
• Go to college, trade school or graduate school.
• Work in a hospital, medical facility, child care center or school.
• Plan to travel overseas or take a cruise.

The vaccine is not suggested for:

• Pregnant people or people who plan to get pregnant within the next four weeks.
• People who have had a life-threatening allergic reaction to gelatin, the antibiotic neomycin or a prior dose of MMR vaccine.

If you have cancer, a blood disorder or another disease, or you take medicine that affects your immune system, talk to your healthcare professional before getting an MMR vaccine.

Side effects of the vaccine

Most people have no side effects from the vaccine. For some people, minor side effects may appear about two weeks after the first vaccine. These can include:

• Sore arm where the shot was given.
• Fever.
• Mild rash where the shot was given.

Symptoms are less likely to happen after the second shot.

A few people get:

• Short-lived joint pain or stiffness. This is more likely to happen to teens or adults assigned female at birth who weren't already immune to rubella.
• Swelling of the glands in the cheeks or neck.
• Seizures that happen with a fever.
• Low level of cells in the blood that help with clotting, called platelets. This can cause unusual bleeding or bruising.
• Rash all over the body.
• Serious allergic reactions. These happen very rarely.

Preventing others from getting rubella

If you've been in contact with the rubella virus and get rubella, you can help keep friends, family and co-workers safe by telling them about your diagnosis and keeping your distance. If your child has rubella, let the school or child care provider know.

The rubella rash can look like many other viral rashes. So healthcare professionals most often confirm rubella with the help of lab tests. You may have a virus culture or a blood test.

These tests can find rubella antibodies in your blood. These antibodies show whether you've had a recent or past infection or a rubella vaccine.

No treatment makes rubella infection clear up faster. And symptoms often are mild and don't need to be treated. But healthcare providers usually say to stay away from others while infected. It's most important to stay away from pregnant people.

Stay away from others as soon as you suspect rubella. Stay away until at least seven days after the rash goes away.

Support of an infant born with congenital rubella syndrome depends on how serious the infant's condition is. Children who have more than one complication may need early treatment from a team of specialists.

A person with rubella needs simple self-care measures. These include:

• Bed rest.
• Acetaminophen (Tylenol, others) for relief from fever and aches.

Do not give children or teenagers aspirin. Aspirin has been linked to Reye's syndrome, a rare life-threatening condition, in children or teenagers who have the flu or chickenpox.

Before your appointment, write down questions you have. Your healthcare professional is likely to ask you questions as well, such as:

• Have you been vaccinated for rubella?
• How long have you had symptoms, such as a rash or aching joints?
• Have you been around anyone who had rubella?
• Have you traveled to other countries in recent weeks? Which countries?
• Does anything seem to make your symptoms better?
• Does anything seem to make your symptoms worse?

When you go to your appointment, tell the people at the check-in desk that you suspect an infectious disease. You and your child may be asked to wear a face mask. Or you may be shown to an exam room right away.