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Rubella (German measles)

child with rubella rashRubella (German measles) is viral illness transmitted by direct contact with saliva or droplets from the saliva of an infected person. Humans are the only known host of the rubella virus.
  
It causes a transient red rash, swollen lymph glands around the ears and back of head, and occasionally in adults, arthritis and arthralgia (pain in a joint caused by inflammation). 
 
However, if a pregnant woman contracts rubella it can cause serious birth defects to her unborn baby.
 
Rubella is one of a number of notifiable diseases in the UK. Any doctor who suspects that a patient has mumps is required by law to report it.
 
Rubella can be prevented by a highly effective and safe vaccine which is part of the measles-mumps-rubella (MMR) immunisation. More information about rubella is available from NHS Direct Wales Online.
 

Who gets it and how serious is it?

Rubella can be caught at any age. Having rubella once usually confers lifelong immunity to catching it again.
 
Rubella is very rarely a serious disease. However, if caught in pregnancy, rubella can cause severe abnormalities in the developing foetus (called Congenital Rubella Syndrome, CRS). These include mental handicap, cataract, deafness, cardiac abnormalities, retardation of intra-uterine growth and inflammatory lesions of brain, liver, lungs and bone marrow. The risk of abnormalities varies depending at what stage of pregnancy rubella is contracted. 
 

Treatment

There is no specific treatment for rubella. Treatment should be based on alleviating symptoms.
 

How common is it?

Rubella immunisation was introduced in the UK in 1970 for pre-pubertal girls and non-immune women of childbearing age, to protect them from the risks of rubella in pregnancy. Before the introduction of rubella immunisation, there were as many as 70 cases of Congenital Rubella Syndrome (CRS) during epidemic years and approximately 10 times this number of terminations of CRS-affected foetuses.
 
The introduction of MMR has led to a fall in the number of cases of rubella in the community and in pregnancies complicated by maternal rubella.
The number of confirmed cases of rubella in the UK and Wales is low with nine cases recorded between January 2000-November 2012.
 
More information about the monitoring of rubella is available from the Public Health Wales Division microsite from the link: rates and surveillance of rubella in Wales 
 

Prevention

Rubella can be prevented by a highly effective and safe vaccine. This is part of the measles-mumps-rubella (MMR) immunisation.
 
A complete course of the two doses will protect over 95% of children against measles, mumps and rubella.  This also prevents rubella from circulating in the community and reduces the risk of non-immune pregnant women from becoming infected.
 
The MMR vaccine has been used for over 30 years (it was introduced in the US in the 1970s), is currently used in over 100 countries, and more than 500 million doses have been given. 
 
Studies from around the world have shown MMR to be a highly effective vaccine, with an excellent safety record. The NHS Choices website has more information about this and other vaccines.
 

Minimising impact in Wales

One important role of Public Health Wales is the collection and interpretation of data about the levels of infectious disease in the Welsh population. Key infections, including rubella, are under constant surveillance, to detect significant trends, to evaluate prevention and control measures and to alert appropriate professionals and organisations to infectious disease threats.
 
The most effective method of controlling rubella is by maintaining high levels of immunisation among vulnerable groups or whole populations. Public Health Wales contribute to this through the work of the Vaccine Preventable Disease Programme (VPDP) and Local Health Protection Teams (HPTs). These support WAG in setting a strategic direction for immunisation services, support LHBs in managing local services and achieving targets, and support General Practice and Trusts delivering services. Public Health Wales supported the implementation of the 2005/6 MMR catch up campaign in Wales.
 
Uptake and coverage of all recommended childhood immunisations are monitored and reported by Public Health Wales quarterly and annually at local and national levels in the COVER Reports for scheduled childhood immunisations.
 

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Last updated: 04 December 2012