[1] Infection during early pregnancy may result in a miscarriage or a child born with congenital rubella syndrome (CRS).

[3] Symptoms of CRS manifest as problems with the eyes such as cataracts, deafness, as well as affecting the heart and brain.

However, the primary symptom of rubella virus infection is the appearance of a rash (exanthem) on the face which spreads to the trunk and limbs and usually fades after three days, which is why it is often referred to as three-day measles.

Other symptoms include low-grade fever, swollen glands (sub-occipital and posterior cervical lymphadenopathy), joint pains, headache, and conjunctivitis.

Forchheimer spots occur in 20% of cases and are characterized by small, red papules on the area of the soft palate.

[13] In children, rubella normally causes symptoms that last two days and include: In older children and adults, additional symptoms may be present, including[citation needed] Severe complications of rubella include: Coryza in rubella may convert to pneumonia, either direct viral pneumonia or secondary bacterial pneumonia, and bronchitis (either viral bronchitis or secondary bacterial bronchitis).

The syndrome (CRS) follows intrauterine infection by the rubella virus and comprises cardiac, cerebral, ophthalmic, and auditory defects.

[3] The disease is caused by the rubella virus, in the genus Rubivirus from the family Matonaviridae,[21] that is enveloped and has a single-stranded RNA genome.

The virus has teratogenic properties and is capable of crossing the placenta and infecting the fetus where it stops cells from developing or destroys them.

[26] Rubella infections are prevented by active immunization programs using live attenuated virus vaccines.

Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease.

[32] In susceptible people passive immunization, in the form of polyclonal immunoglobulins, appears effective up to the fifth day post-exposure.

[13][34] Management for ocular congenital rubella syndrome (CRS) is similar to that for age-related macular degeneration, including counseling, regular monitoring, and the provision of low vision devices, if required.

[citation needed] Vaccination has interrupted the transmission of rubella in the Americas: no endemic case has been observed since February 2009.

[39] During the epidemic in the US between 1962 and 1965, rubella virus infections during pregnancy were estimated to have caused 30,000 stillbirths and 20,000 children to be born impaired or disabled as a result of CRS.

[40][41] Universal immunisation producing a high level of herd immunity is important in the control of epidemics of rubella.

Outbreaks of rubella occurred amongst many young men in the UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and were susceptible.

German physician and chemist, Friedrich Hoffmann, made the first clinical description of rubella in 1740,[46] which was confirmed by de Bergen in 1752 and Orlow in 1758.

[47] In 1814, George de Maton first suggested that it be considered a disease distinct from both measles and scarlet fever.

[52] In 1914, Alfred Fabian Hess theorised that rubella was caused by a virus, based on work with monkeys.

[53] In 1938, Hiro and Tosaka confirmed this by passing the disease to children using filtered nasal washings from acute cases.

Subsequently, ophthalmologist Norman McAllister Gregg found 78 cases of congenital cataracts in infants and 68 of them were born to mothers who had caught rubella in early pregnancy.

He described a variety of problems now known as congenital rubella syndrome (CRS) and noticed that the earlier the mother was infected, the worse the damage was.

[54] The virus was isolated in tissue culture in 1962 by two separate groups led by physicians Paul Douglas Parkman and Thomas Huckle Weller.

[55][56] In 1967, the molecular structure of rubella was observed under electron microscopy using antigen-antibody complexes by Jennifer M. Best, June Almeida, J E Banatvala and A P Waterson.

[50] In the early 1970s, a triple vaccine containing attenuated measles, mumps and rubella (MMR) viruses was introduced.

"[61] The declaration was made after 165 million health records and genetically confirming that all recent cases were caused by known imported strains of the virus.