The signs and symptoms of rubella are often so mild they're difficult to notice, especially in children. If signs and symptoms do occur, they generally appear between two and three weeks after exposure to the virus. They typically last about one to five days and may include:

• Mild fever of 102 F (38.9 C) or lower
• Headache
• Stuffy or runny nose
• Inflamed, red eyes
• Enlarged, tender lymph nodes at the base of the skull, the back of the neck and behind the ears
• A fine, pink rash that begins on the face and quickly spreads to the trunk and then the arms and legs, before disappearing in the same sequence
• Aching joints, especially in young women

The cause of rubella is a virus that's passed from person to person. It can spread when an infected person coughs or sneezes, or it can spread by direct contact with an infected person's respiratory secretions, such as mucus. It can also be transmitted from pregnant women to their unborn children via the bloodstream.

A person with rubella is contagious for one to two weeks before the onset of the rash until about one or two weeks after the rash disappears. An infected person can spread the illness before the person realizes he or she has it.

Rubella is rare in the United States because most children receive a vaccination against the infection at an early age. However, cases of rubella do occur, mostly in unvaccinated foreign-born adults.

The disease is still common in many parts of the world. The prevalence of rubella in other countries is something to consider before going abroad, especially if you're pregnant.

Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis).

However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe, and in some cases, fatal. Up to 80 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including:

• Growth retardation
• Cataracts
• Deafness
• Congenital heart defects
• Defects in other organs
• Intellectual disabilities

The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous.