Rubella vs. Rubeola (Measles): How to Spot the Differences, With Images

Rubella and rubeola (measles) are two viral illnesses that share some similarities. They both cause fever and a skin rash, and both can be prevented with a vaccine. Their names even sound alike. But, that's where the similarities end.

Rubeola is more contagious than rubella, and it can also cause serious health complications that can lead to death. Even though both of these viruses have been officially eliminated in the U.S., there have been more rubeola outbreaks because fewer people are getting vaccinated.

Here we'll take a look at the key differences between these two viruses, including how their rash and other symptoms develop.

Rubella

Rubella, also called German measles, is a very contagious viral infection. It spreads when you come into contact with respiratory droplets from someone who has rubella. This can happen when they cough or sneeze near you, or if you both touch the same surface or breathe the same air.

You can prevent rubella with the MMR (measles, mumps, and rubella) vaccine, which is usually given in two doses during childhood. Once you have been fully vaccinated, you have lifelong protection against rubella. The vaccine helped eliminate rubella in the U.S. in 2004. However, there are still many cases of rubella around the world. But people who get infected in other regions of the world can still bring the virus to the U.S.

Rubella symptoms

In most people, rubella is pretty mild and it may not even cause noticeable symptoms. Rubella usually affects children and adults who aren't immune to it (meaning they've never had the vaccine or been infected with the virus before). Symptoms can include:

• Low-grade fever

• Tiredness

• Headache

• Sore throat

• Swollen lymph nodes

• Rash

• Joint pain (in adults)

Rubella rash

A rash may be the first sign of rubella, especially in children. It usually starts as small patches and bumps on the face that are pink in fair skin and purple or skin-colored in darker skin. The spots grow together to form larger spots, and the rash quickly spreads to the arms, legs, and torso. It doesn't usually affect the palms or soles. It usually fades after 3 days in the same order it appeared.

Complications of rubella

Up to 70% of women and adolescents who get rubella may develop arthritis (joint pain). This usually involves the fingers, wrists, knees, and ankles. In very rare situations, rubella can cause more serious problems like bleeding problems, brain infections, and heart inflammation.

Rubella is most dangerous for pregnant women because the virus can spread to the unborn baby and cause a miscarriage or serious birth defects (called congenital rubella syndrome).

Pictures of rubella rash

These rubella skin rash pictures can help you know what it looks like.

Rubeola (Measles)

Rubeola, better known as measles, is a respiratory infection caused by the paramyxovirus. It's one of the most contagious diseases in the world. Rubeola spreads by respiratory droplets through coughs, sneezes, and being in close contact with someone who has measles.

Rubeola can cause a variety of respiratory symptoms, like a cough and runny nose. It can also cause serious complications, like pneumonia, that can lead to hospitalization and death. This is more likely to happen in young children, pregnant women, and people with a weakened immune system.

The MMR vaccine is the best way to prevent rubeola. Because of the vaccine, rubeola was officially eliminated in the U.S. in 2000. In recent years, however, measles outbreaks have been increasing in the U.S. because fewer people are getting vaccinated.

Rubeola (measles) symptoms

Rubeola can affect anyone who isn't immune to it. This includes people who haven't been vaccinated or haven't had rubeola in the past. The first symptoms of rubeola include:

• High fever

• Runny nose

• Cough

• Red and watery eyes

Rubeola (measles) rash

Two to 3 days after the first symptoms begin, tiny white spots (called Koplik spots) can appear in the mouth, usually inside the cheek. Soon after, a rash starts as small flat spots on the face and around the hairline that spread down to the neck, arms, torso and legs. The spots are pink or red in fair skin and violet, brown or skin-colored in darker skin. Like rubella rash, measles rash typically spares the palms and soles. After a few days, the rash disappears in the same order it appeared.

Complications of rubeola

Anyone with rubeola can get more serious health complications. But children and people who are pregnant, not vaccinated, malnourished, or immunocompromised are at higher risk. Rubeola complications include:

• Ear infections

• Diarrhea

• Pneumonia

• Brain inflammation

• Death

Rubeola infection during pregnancy can also cause fetal complications. These include premature birth, low birth weight, and miscarriage.

Pictures of rubeola (measles) rash

Below are some rubeola rash examples.

What's the difference between rubella and rubeola?

This chart summarizes the differences between these two viruses.

Images used with permission from VisualDx (www.visualdx.com).