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 this short film, Ian Capon talks about his experience of CRS, and advises women planning a family to check their rubella immunisation status.
Some people do not show any symptoms, but common symptoms include:
Complications in pregnancy can be very serious for the baby. See 'More information' below.
It is normally spread by water droplets passed into the air by an infected person.
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. From 2000 to 2013 there have been an average of 26 confirmed cases of rubella each year. 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, as the MMR uptake rate has not been consistently high over the last few years, women planning to have a baby should check whether they have had two doses of MMR vaccine, and, if not, should talk to their GP about getting vaccinated before they start trying to get pregnant. The rubella immunity test offered during pregnancy is of no use in protecting that pregnancy - it is too late by then.
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.