Before the MMR vaccine was introduced in the UK, rubella was commonly seen in children between the ages of 4 to 9 years and a further 80% of adults had evidence of previous infection (1,2)
- 200-300 congenital rubella syndrome (CRS) births were seen during non epidemic years with the episodes increasing in epidemic years (1)
Since the introduction of MMR vaccine in 1970, CRS has greatly reduced in recent years
- the vaccine was given to pre-pubertal girls and non-immune women of child-bearing age with the aim of protecting them (2)
- during the period from 1971-1975, an average of 48 CRS births and 742 terminations were seen annually which declined to just over 20 CSR births and 50 terminations a year during the years 1986-1990 (1,2) In 1988 universal rubella vaccination was introduced with the aim of interrupting circulation of rubella amongst young children
- a considerable decline in rubella infection was seen in young children as well as in pregnant women
- in 1994 combined measles-rubella (MR) vaccine was used in schools due to an increase in notification and laboratory-confirmed cases of rubella during the previous year
- in 1996 two doses MMR vaccine was commenced (2)
- in 2008 there were 16 laboratory-confirmed cases of rubella out of 888 cases tested for rubella
- in England and Wales the total number of laboratory confirmed cases of rubella was 5 in 2015, 2 in 2016 and 3 in 2017.
Higher rubella susceptibility rates are seen among ethnic minority women when compared to white women in the UK. In recent years mothers of babies diagnosed with CR has been roughly divided into three groups:
- women who acquired the infection in early pregnancy when they were away from the country, mostly in Africa or Asia (imported infections)
- women who acquired the infection in the UK (many within two years of arrival) but born abroad
- women who were born in UK and acquired their infection in the UK (1)
Note
Among 194 WHO Member States, 173 (90%) included rubella-containing vaccine in their immunisation schedules in 2022, an increase from 132 (68%) in 2012, and 68% of the world's infants were vaccinated against rubella in 2022 (4)
References:
- Tookey P. Rubella in England, Scotland and Wales. Eurosurveillance 2004;9(4):21-3
- Immunisation Against Infectious Disease - "The Green Book". Chapter 28 Rubella (August 2006)
- Health Protection Agency (HPA). Rubella notifications (confirmed cases), England and Wales, 1995 - 2009 by quarter
- Ou AC, Zimmerman LA, Alexander JP Jr, et al. Progress toward rubella and congenital rubella syndrome elimination - worldwide, 2012-2022. MMWR Morb Mortal Wkly Rep. 2024 Feb 29;73(8):162-7.