Abstract
Rubella vaccination has been included in the United Kingdom’s (UK) routine childhood schedule for nearly 30 years. The UK achieved World Health Organization (WHO) elimination status in 2016 and acute rubella infections are rare. In the period 2003–16, 31 rubella infections in pregnancy (0.23 per 100,000 pregnancies) were identified through routine surveillance, of which 26 were in women who were born abroad. Five of the 31 rubella infections led to congenital rubella syndrome in the infant and three had confirmed congenital rubella infection without congenital rubella syndrome. An additional seven babies were identified with congenital rubella syndrome, although rubella infection in pregnancy had not been reported. Place of birth was known for six of these seven mothers, all of whom were born outside the UK, and in five cases maternal infection was acquired abroad. WHO Europe has set targets for measles and rubella elimination and prevention of congenital rubella syndrome by 2015. Vaccination uptake and rubella immunity is high in the UK population and most infections in pregnancy since 2003 were acquired abroad and in unvaccinated women. Every contact with a health professional should be used to check that women are fully immunised according to UK schedule.
Highlights
Rubella is usually a mild, sometimes asymptomatic illness in childhood, the consequences of rubella infection in pregnancy can be devastating
Rubella can be mistaken for a number of other viral infections, and in order to monitor progress towards elimination it is essential that countries across Europe have robust surveillance systems in place to identify all suspected cases and reliably confirm or exclude rubella and congenital rubella infection (CRI) using appropriate laboratory methods [4]
This paper summarises cases of laboratory-confirmed rubella infection in pregnancy (IIP), CRI and congenital rubella syndrome (CRS) reported to Public Health England (PHE) and other national surveillance programmes in the United Kingdom (UK) between 2003 and 2016
Summary
Rubella is usually a mild, sometimes asymptomatic illness in childhood, the consequences of rubella infection in pregnancy can be devastating. Surveillance systems and laboratory confirmation of rubella and congenital rubella cases vary across Europe. Despite the elimination goals set for the WHO European Region, three of 28 European Union (EU) countries do not have national surveillance systems for all rubella cases [5,6]. The United Kingdom (UK) vaccination strategy and programme surveillance is very similar to other western European countries and is based on laboratory-confirmed cases. It is, the only country to perform routine IgM confirmatory testing of oral fluid of notified cases (since 1994), which has strengthened surveillance and improved ascertainment [7,8,9]
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