Rubella and rubeola — also known as German measles and measles, respectively — are both contagious viral infections that appear with fever and then a rash. The names and symptoms of these infections are similar, so it can be difficult to tell the difference between them.
Both infections are most common in young children but can also occur in adults. Infections are less common now, thanks to vaccines developed in the 1960s. But they can still be dangerous, especially to infants and young children.
In this article, you will learn how to tell the difference between these two viral illnesses, what each rash looks like, when to expect other symptoms, and how you can prevent and treat these infections.
Both rubella and rubeola are viral infections.
Rubella, also known as German measles, is an infection by the rubella virus.
Rubeola, often referred to simply as measles, is an infection by a virus in the paramyxoviridae family.
Both are highly contagious airborne viruses. That means they spread through tiny droplets in the air, like in a cough or sneeze. You can also get either virus by touching the same surface or breathing the same air as a person with an infection.
With both of these infections, it can take about 1 to 3 weeks after exposure to develop symptoms. This is called the incubation period. Sometimes, rubella symptoms can be so mild you might not even notice that you’re sick.
Once they do appear, the most common symptoms include fever, a rash that starts on the head or face, and red or irritated eyes. Beyond these, there are some key differences.
Fever
With rubella, a high fever will begin suddenly and appear before a rash. The fever usually lasts for 3 or 4 days. The rash appears as the fever fades.
While rubeola also usually appears with a high fever, a rash will develop a few days after symptoms start. The rash often appears while the fever continues.
Rash
Rashes are a defining feature of both of these infections. Both typically begin on the head or face and spread to other parts of the body. But the coloring and texture of the two rashes are different.
A rubella rash often begins on the face with fine pink bumps. It may be slightly itchy.
A rubeola rash appears with flat spots that are deeper pink or red. It usually starts small, eventually spreading to appear as one large rash. As the rubeola rash fades, it turns a bit brown, and your skin may peel or flake.
Other symptoms
Other rubella symptoms can include:
- headache
- pink eye or mild swelling and redness of the eye
- general achiness
- cough
- stuffy nose
- swollen lymph nodes
Other rubeola symptoms can include:
- cough
- runny nose
- red and watery eyes
- tiny white spots in the mouth (Koplik spots)
| Rubella | Rubeola | |
|---|---|---|
| Incubation period | 12–23 days | 7–14 days |
| Symptoms duration | 1–5 days | 7–14 days |
| Contagious period | 7 days before or after rash appears | 4 days before or after rash appears |
Both of these viruses have the potential to cause long-term complications.
Either virus is particularly dangerous for pregnant women. Rubella can lead to a severe condition called congenital rubella syndrome (CRS). Rubeola can result in premature birth or low birth weight in the babies of infected mothers.
Beyond pregnancy, rubella has the potential to cause lasting joint problems. About
Rubeola, on the other hand, can lead to more serious illness in the short term. Common complications can include bronchopneumonia, middle ear infection, and diarrhea.
People infected with either rubella or rubeola are also at risk of developing an infection in the brain called encephalitis.
Your doctor may be able to diagnose either of these conditions by reviewing your symptoms and looking at your rash. But laboratory testing is the only way to confirm a diagnosis of either rubella or rubeola.
Your doctor may test for either virus using any of:
- throat swab
- a blood or serum sample
- sputum or a respiratory sample
- nasopharyngeal swab
- urine
Since both infections are viral, there is no effective treatment for either. The best treatment is prevention through vaccination.
If you know you’ve been exposed to rubella or rubeola, vaccination with the measles, mumps, and rubella (MMR) vaccine within 3 days of exposure could help reduce the severity of your illness. A doctor may inject you with immunoglobulins to help your immune system fight the infection.
Beyond these measures, doctors can only recommend supportive care to manage symptoms. This can include:
- rest
- acetaminophen or ibuprofen to treat fever
- plenty of fluids
- a humidifier
Vitamin A supplements may also help with measles, but talk to your doctor or pediatrician about specific dosing. The
- 50,000 IU for children under 6 months of age
- 100,000 IU for children between 6 and 11 months of age
- 200,000 IU for children 12 months of age and older
The best way to prevent either of these infections is with the same vaccine. The CDC recommends that children receive two doses of the MMR vaccine. They usually receive the first dose between 12 and 15 months of age and the second dose between 4 and 6 years old.
Older children ages 12 months to 12 years can get the MMRV vaccine, which also protects against varicella (chickenpox). But the CDC
If traveling internationally, babies older than 6 months should receive one dose of the MMR vaccine
Adults who didn’t receive either dose of the MMR vaccine, or who only had one dose as a child, should talk to their doctor about being vaccinated. In particular, people in the following groups should consider vaccination:
- international travelers
- college students
- healthcare workers
- public health workers
Most adults will only need one dose. Adults in high-risk categories usually will receive two vaccine doses spaced
You should not receive either the MMR or MMRV vaccine
Does the MMR vaccine cause autism?
A 1998 study linked the MMR vaccine to an increased risk of autism. That was later debunked and retracted. Numerous studies since have shown no association between the MMR vaccine and autism.
Still, there is hesitation among some parents to have their children vaccinated. This vaccination hesitance, especially regarding the MMR vaccine, has contributed to several measles outbreaks in recent years.
Talk to your doctor or pediatrician if you have concerns about vaccine safety.
Rubella and rubeola, also known as German measles and measles, are both viral illnesses that can cause fever and rash. There are slight differences in the timing of fever, appearance of the rash, and other symptoms. But the same vaccine can prevent both of these infections.
There are no official treatments for rubella or rubeola, but the MMR vaccine can prevent illness and long-term complications associated with both of these infections.
| Rubella | Rubeola | |
|---|---|---|
| Rash characteristics | fine pink spots | flat pink or red spots |
| Fever and rash timing | fever first, then rash without fever | fever first, then rash with fever |
| Symptoms | fever rash pink eye body aches headache cough stuffy nose | fever rash watery eyes cough runny nose white spots in mouth |
