Measles & mumps & rubella – Oh, my!

Published June 28, 2024

The history of these viral diseases stretches back centuries. Measles was documented as early as the 7th century. And by the 10th century, the renowned physician, Rhazes, described it as "more to be dreaded than smallpox." Symptoms of mumps, including swollen glands, were even noted by Hippocrates in the 5th century BCE. But rubella was once confused for a type of measles or scarlet fever. So, it wasn't until 1814 that it finally gained recognition in German medical texts, hence the reason why rubella is sometimes referred to as "German measles."¹ 

So, what exactly are these 3 vaccine-preventable diseases? And why do they continue to pose challenges to global health?

What is measles? What causes it?

Measles is a highly contagious illness caused by the measles virus. Measles is also known as rubeola (roo-bee-oh-luh), red measles, or 10-day measles.²

How does measles spread?

Measles is extremely contagious. A person with the illness can spread it to others for about 8 days (4 days before and 4 days after the rash appears). During this time, the virus is present in their nose and throat. When they cough, sneeze, or talk, they release the virus into the air or onto surfaces – where it survives for about 2 hours. This means you can get measles without direct contact with that person. Simply being where they were, even up to 2 hours later, is enough to lead to infection.³

What are the symptoms of measles?

Measles symptoms typically appear within 7 to 14 days following exposure. Some of the most common include² ³:

• Rash
• High fever (could exceed 104° F)
• Cough
• Runny nose
• Red, watery eyes (pink eye)
• Tiredness

Measles is still a common and often fatal disease in many parts of the world.⁴ It can lead to severe, life-threatening complications in some populations, including²:

• Babies
• Toddlers
• Adults
• Pregnant people
• Those with weakened immune systems

Why are measles cases rising in the US?

In 2000, health officials announced a major achievement: the elimination of measles in the United States. This was due to many people receiving the MMR vaccine to protect against measles, mumps, and rubella.⁵

But in recent years⁵: 

• Kindergarten vaccination rates have fallen below 95% – the level needed to prevent measles outbreaks. And the rates continue to decline 
• Measles cases are rising globally

When US vaccination rates fall, and global cases rise, the disease is more likely to spread in the US. Every year, unvaccinated travelers bring measles into the US after visiting abroad.⁵ Measles is so contagious that it can quickly cause outbreaks in communities where vaccination rates are low.⁴

What is mumps? How does it spread?

Mumps is a highly contagious illness caused by the mumps virus. It mainly spreads by coughing, sneezing, talking, or sharing items like cups or utensils.⁶ A person with mumps remains contagious for about 7 days (2 days before and 5 days after the salivary glands begin to swell).⁷ 

What are the symptoms of mumps?

Mumps symptoms typically appear within 12 to 25 days following exposure.⁷ Some of the most common include⁶:

• Fever
• Headache
• Muscle aches
• Loss of appetite
• Tiredness
• Malaise (overall sense of not feeling well)
• Swollen glands 

Mumps is mild for most people. But in rare cases it can cause serious complications, including⁸:

• Arthritis
• Swelling of the testicles, ovaries, or breasts
• Swelling of the brain: encephalitis (en-sef-uh-lie-tis)
• Swelling of the tissue covering the brain and spinal cord: meningitis (men-in-jye-tis) 
• Temporary or permanent hearing loss

Is mumps still around?

Yes. While mumps isn’t as common in the US due to widespread vaccination, outbreaks do occur. Larger outbreaks still happen in settings where people have frequent, close contact with each other, including⁸:

• Colleges
• Schools
• Correctional facilities
• Close-knit communities

What is rubella? What causes it?

Rubella is a highly contagious illness caused by the rubella virus. It’s also called German measles or 3-day measles, but it’s different from measles. Although both illnesses cause a rash, they’re not the same or caused by the same virus.⁹

How does rubella spread?

Rubella is mainly spread through coughing, sneezing, or direct contact.¹⁰ A person with rubella remains contagious for about 14 days (7 days before and 7 days after the rash appears). 

What are the symptoms of rubella?

Rubella symptoms typically appear within 12 to 23 days following exposure.¹⁰ Some of the most common include⁹:

• Rash
• Low fever
• Cough
• Sore throat
• Runny nose
• Pink eye
• Headache
• Joint pain
• Malaise
• Swollen lymph nodes

Can rubella cause any complications?

While rubella is usually a mild viral illness, it can sometimes lead to serious issues like arthritis, low blood platelet levels, or encephalitis. But the greatest risk of rubella is associated with pregnancy.¹⁰ 

What are the dangers of rubella during pregnancy?

A rubella infection during pregnancy, especially within the first 12 weeks, can severely harm the developing baby. At this critical stage, rubella greatly increases the risk of congenital rubella syndrome (CRS) and pregnancy loss through miscarriage or stillbirth.¹¹

The rubella virus can cross the placenta and spread to the developing baby, potentially causing CRS. This condition can affect fetal development and lead to various health conditions after birth, including¹¹:

• Bone disease
• Cataracts and glaucoma
• Developmental delays
• Diabetes
• Enlarged liver or spleen
• Hearing loss
• Heart disease
• Inflammation of the brain
• Inflammation of the lungs
• Intellectual disabilities
• Low birth weight
• Skin rash
• Thyroid disease

The health conditions CRS causes often require lifelong treatment and care. Once CRS develops, doctors can treat specific symptoms, but there's no known cure for the underlying condition.¹¹

No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure it is medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the option to discuss your test results with an independent physician; however, you are also encouraged to speak with your primary healthcare provider.