Rubella (German measles) is a rare and usually mild illness that can cause problems in pregnancy. Here we discuss rubella symptoms, what to do if you are exposed and immunisation.
German measles is the common name for rubella. It is a viral infection which causes a reddish-pink rash and a high temperature (over 38°C). The virus is passed on through coughs and sneezes, and rubella in pregnancy is usually only a concern if it is caught by a woman in the first 16 weeks. It is rare in the UK because most people are immunised in childhood.
Rubella in pregnancy
If you catch German measles early on in pregnancy, the development of your baby’s heart, brain and eyes may be affected. If caught later in pregnancy, the baby is less at risk although their hearing may be damaged. The birth defects caused by the rubella virus are known as congenital rubella syndrome (CRS).
For a pregnant woman who is not already immune, it is important to avoid contact with anyone who has German measles. Rubella symptoms are quite non-specific which can make it difficult to diagnose. You may feel tired, have a head-ache and/or swollen lymph nodes, as well as pain in your joints and red eyes prior to the occurence of a rash.
Congenital rubella syndrome is extremely rare in the UK. However, if you are pregnant and you think you may have been exposed to rubella then contact your GP. They will be able to refer you for tests to see if you have contracted rubella.
Currently, rubella susceptibility screening consists of a blood test offered to all pregnant women to establish whether they are immune to rubella. (This will change in April 2016 – see update below). Most women are immune and no further action is required.
Women who are not immune are advised to avoid contact with the virus and offered the measles, mumps and rubella (MMR) vaccination after the birth of the baby, before any further pregnancies.
Although rubella is uncommon here, the condition is still widespread in many parts of the world, such as Africa and Asia. If you’re a new entrant to the UK, register with a GP and ask for the MMR. If you’re planning to travel outside of the UK it’s also worth checking if you are up to date with your GP.
It is possible to have the MMR vaccination at any age, so if you suspect that you, or your children, are not up-to-date with your MMR, contact your GP.
From 1 April 2016, rubella susceptibility screening in pregnancy will end in England. The decision to stop screening follows a review of evidence by the UK National Screening Committee (UK NSC) in 2003 and 2012. Reasons for the change in guidance include the fact that rubella infection levels in the UK are so low they are defined as eliminated by the World Health Organisation and that rubella infection in pregnancy is very rare.
Public Health England (PHE) offers the following advice to women on the MMR vaccination:
If you are planning a pregnancy:
- your MMR status should be checked at appropriate opportunities, for example when you register with a new GP, attend a family planning clinic or travel abroad.
- you should receive the vaccine before trying for a baby; two doses will also give protection against mumps and measles.
Measles can also be serious in pregnancy, sometimes leading to miscarriage, stillbirth or premature birth. If you are not sure whether you are vaccinated, having another MMR vaccine prior to becoming pregnant will not cause harm.
If you are already pregnant and not up-to-date with the MMR vaccination, or you’re unsure:
- speak to your GP or your midwife when you discuss the whooping cough and influenza vaccines.
- the MMR vaccine should be given soon after you give birth which will help protect you and your family against future measles, mumps and rubella.
- the MMR vaccine can be given to women who are breastfeeding without any risk to their baby.
Children are immunised against rubella via the MMR vaccine as part of their routine childhood immunisation programme.
Last updated: January 2016
NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.
Read more about rubella susceptibility screening in pregnancy on PHE website.