Rubella (German Measles)

Key disease facts

Rubella (or German measles) is an infectious disease caused by a virus. It is not normally serious, and some people do not even show any symptoms.

However, the disease is very dangerous for pregnant women, because it can cause miscarriage or serious abnormalities in the unborn baby. These include learning disabilities, eye cataracts leading to severe visual impairment, deafness, heart abnormalities, stunted growth, and inflammatory lesions (damaged tissue) in the brain, liver, lungs and bone marrow. If the mother is infected in the first ten weeks of pregnancy, 90% of surviving babies will show one or more defect. Babies affected in this way are said to have congenital rubella syndrome (CRS). See 'More information' below.

In 2015 the World Health Organization announced that the UK had eliminated rubella. This means there are now very few cases of rubella each year in the UK - not enough for the disease to circulate widely in the population.

In this short film, Ian Capon talks about his experience of CRS, and advises women planning a family to check their rubella immunisation status.

What are the symptoms?

Some people do not show any symptoms, but common symptoms include:

  • mild fever
  • cold-like symptoms
  • feeling generally unwell
  • conjunctivitis
  • a rash on the face and neck

Complications in pregnancy can be very serious for the baby. See 'More information' below.

How is it passed on?

It is normally spread by water droplets passed into the air by an infected person.

What protection is available?

The recommended way to get protection against rubella is vaccination, through the MMR vaccine.

More information about the disease

Before the introduction of the rubella vaccination in the early 1970s, the majority of people (80%) developed rubella, and 200-300 babies were born each year with congenital rubella syndrome. The vaccination of teenage girls protected any babies they went on to have, but rubella continued to be widespread, and CRS continued to affect a significant number of babies. Since 1970, a total of 800 babies have been born with disabilities and serious health conditions due to CRS, and over 6,500 mothers have aborted their pregnancy due to CRS.

The introduction of the MMR vaccine in the UK in 1988 meant that now all children were immunised against rubella. This led to a dramatic reduction in the circulation of the rubella virus. Since 2013 there have been hardly any confirmed cases of rubella each year in the UK (see the Public Health England data ). This low incidence of disease means that a very low number of pregnant women are affected, and very few babies are now born in the UK with CRS. The MMR programme is therefore much more effective in preventing CRS than the vaccination of girls alone.

However, all women who are thinking about becoming pregnant are advised to check that they have been vaccinated against rubella (usually as part of the MMR vaccine). It is too late to be vaccinated against rubella once you are pregnant.

Since April 2016, pregnant women in the UK have not been offered screening for rubella susceptibility. Previously, all pregnant women were offered a blood test to check whether they were immune to rubella. This change reflects the great success of the MMR vaccine in reducing transmission of the rubella virus to almost zero. This means that pregnant women are protected from rubella by herd immunity. In 2011, a review by the UK National Screening Committee (UK NSC) found that there were almost no cases of congenital rubella syndrome in the UK (less than 1 case per 100,000 live births). According to World Health Organization criteria, this effectively means the disease has been eliminated. The UK NSC therefore recommended that the screening programme should stop. See the Public Health England statement for more information. Women of child-bearing age will still be offered the MMR vaccine if they have not already had it, or are not sure if they have had it.

CRS continues to be a real problem worldwide - according to the World Health Organization, there are at least 100,000 cases of CRS every year in the developing world.

Page last updated: 
Monday, October 2, 2017