Rubella and pregnancy

Rubella can seriously affect pregnant women, damaging their unborn child - particularly the foetus’ sight, hearing, heart and brain develop.

Infection in the first 10 weeks of pregnancy causes 90% of infants to be damaged - typically their heart, eyes, ears and brain, often in combination. In the next six weeks a third of infants are affected, usually but not always restricted to hearing loss. Later infection is rarely associated with damage, and is referred to as congenital rubella infection.

What doesn’t work?

Avoiding people who have rubella is not an effective way to stop yourself from catching the disease and passing it on to your unborn child (or your friends’ unborn children) because:

• People are infectious before they develop the symptoms
• Some people who catch rubella (and can then pass it on) do not develop any symptoms
• Rubella is a rash disease and can appear, even to a GP, like other rash diseases. The only way to confirm a diagnosis is through laboratory tests, by which time it is too late…

Immunisation is the only way to protect against rubella.

We protect unborn children by:

• Ensuring young children receive two doses of the MMR vaccine.
• Children who have missed or delayed having catch up vaccinations at any stage.
• Women who are thinking about becoming pregnant having their immunity tested.

Who is at risk?

In the UK today there is very little wild rubella virus circulating, largely due to the success of the vaccination programme. However, we can’t be complacent – there are localised outbreaks and lower than desired vaccination rates over a 10 year period mean that we risk seeing rubella return if we are not careful. What we do know is that if there are significant outbreaks of rubella in this country, as we saw in 1996, then we will see women who are pregnant pass on the infection to their unborn child, who in turn may be born with multiple disabilities.

Research shows that on average between 1.5% and 4% of women during their first pregnancy are susceptible to rubella; the figures are lower for subsequent pregnancies – between 0.5% and 1.5%1. These will be women who have not been immunised or infected in the past. There is evidence that susceptibility to rubella is higher in some minority ethnic groups. For example a study in the North Thames area showed that 15% of women of Sri Lankan origin were susceptible to rubella.

In recent years, of all the cases where a child is born damaged because of rubella:

• One third were born to women who acquired the rubella infection abroad, early in pregnancy (mostly in their country of origin)
• One third were born to women who were born abroad but who acquired the rubella infection in the UK (most within two years of arrival)
• One third were born to women who were born in the UK and acquired the rubella infection in the UK. Sense believes that health professionals and others should pay particular attention to women who may be at risk of catching rubella by checking their susceptibility and advising immunisation where necessary.

1 Vyse et all, Epidemiol Rev 2002

Thinking of getting pregnant?

Sense and the Department of Health have jointly produced a leaflet which answers questions you may have if you are thinking of becoming pregnant such as how to protect your unborn baby and the unborn children of those that you are close to. This publication is available in English, Bengali and Tamil and can be downloaded below. We have also produced this information in audio format in Bengali and Tamil.

Download the leaflet

in standard PDF format (243Kb)
in accessible format (9Kb).
in Bengali (pdf, 280kb)
in Tamil (pdf, 2Mb)
Audio file in Bengali (mp3, 14Mb)
Audio file in Tamil (mp3, 14Mb)

For health workers

The flyer provides quick information for mothers and mothers-to-be on Rubella and its effects, and where to go for further information. You can download it and print multiple copies of it (PDF, 156Kb) for your clients.

You can download the A3 poster and print it (PDF, 236Kb) for your health practice//clinic. The poster signposts your clients where to go for further information.