Rubella

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent:  Rubella virus

Description of illness: Rubella is a brief, vaccine-preventable viral illness characterized by a mild maculopapular rash that is rare in the United States but can be introduced by ill travelers. The rubella rash occurs in 50%-80% of rubella-infected persons and is sometimes misdiagnosed as measles or scarlet fever. Children usually develop few or no symptoms, but adults may experience a 1-5 day prodrome of low-grade fever, headache, malaise, mild coryza, and conjunctivitis.  Arthritis occurs in up to 70% of infected women, but is rare in men or children. Rubella is a contagious illness transmitted through direct or droplet contact from nasopharyngeal secretions with an incubation period of 17 days (range: 12-23 days). A person is most infectious when rash is erupting, but can shed the virus from 7 days before to 7 days after rash onset.  The most serious complication from rubella is the harm an infection can cause an unvaccinated pregnant woman’s developing baby, complications includes: miscarriage; stillbirths; and severe birth defects, known as congenital rubella syndrome (CRS).

Interactive Disease Data


Laboratory Reporting for this Disease

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

 

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Rubella (German measles) is a vaccine-preventable viral illness that is often mild and sometimes subclinical (up to about half of infections); clinical diagnosis is unreliable because the rash can resemble many other febrile rash illnesses.
  • Typical clinical features include a mild maculopapular rash (often starting on the face and becoming generalized within 24 hours, usually lasting ~3 days), lymphadenopathy (classically posterior auricular/suboccipital), and low-grade fever; adults may have additional symptoms such as sore throat and conjunctivitis, and arthralgia/arthritis can occur (especially in adult women).
  • Transmission occurs primarily through direct or droplet contact with nasopharyngeal secretions. CDC notes people are generally contagious from 7 days before to 7 days after rash onset, and recommends isolating patients for 7 days after rash onset; suspected cases should be isolated and reported promptly to public health.
  • Testing is needed to confirm suspected rubella: CDC recommends collecting specimens for PCR viral detection (e.g., nasopharyngeal/throat swab or urine) and serology (blood). There is no specific antiviral therapy—management is supportive, plus infection control and public health response. In Tennessee, rubella (including congenital rubella syndrome) is listed as a next-business-day reportable condition.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What Is It

Rubella (German measles) is a contagious disease caused by a virus. Many infections are mild, but rubella is especially dangerous during pregnancy because it can cause miscarriage or serious birth defects, known as congenital rubella syndrome (CRS).

Signs and Symptoms

Rubella can cause a rash that often starts on the face and spreads to the rest of the body, along with low-grade fever and swollen glands. Some people may have very mild illness or no symptoms, which can make it hard to recognize.

How It Spreads

Rubella spreads through respiratory droplets when an infected person coughs or sneezes. Because infection can be mild or symptom-free, people may not realize they are contagious.

Prevention

The best protection is the measles, mumps, and rubella (MMR) vaccine, which helps prevent rubella and protects people who are at the highest risk for serious outcomes, including pregnant women and infants.

Pregnancy and Infant Considerations

Rubella infection during pregnancy can result in congenital rubella syndrome (CRS), which can cause serious birth defects. Protecting pregnant women depends on community vaccination and ensuring individuals are vaccinated before pregnancy when possible; MMR is not given during pregnancy, so prevention focuses on being up to date on MMR vaccination and avoiding exposure when rubella is suspected.

This Page Last Updated: March 25, 2026 at 8:53 PM