Congenital Rubella Syndrome fact sheet

What is Congenital Rubella Syndrome?
The congenital rubella syndrome (CRS) is an illness of infants born to women who had rubella (German measles) while they were pregnant, usually during the first three months of pregnancy. CRS can cause defects such as cataracts, deafness, heart defects, and mental retardation.

What causes CRS?
CRS is caused by the rubella virus

How can a woman find out if she is susceptible to rubella?
There is a simple blood test that can determine whether a person is immune to rubella. The blood test shows whether or not a person has antibodies against the virus in the blood. People who have had the illness or were vaccinated against are immune to rubella.

Can congenital rubella syndrome be prevented?
Non-immune women can be vaccinated with the rubella vaccine alone or with a combination vaccine such as measles-mumps-rubella (MMR), so that her future children will be protected from the CRS. A blood test for immunity to rubella before they become pregnant can be carried out. Women who missed being tested prior to pregnancy are routinely tested during an early prenatal visit. If a pregnant woman is not immune, she should avoid anyone who has this illness. There is no effective treatment for rubella during pregnancy, nor is there an effective way to prevent rubella in a susceptible woman who is exposed to the illness.

Pregnant women who are not immune also should be vaccinated after delivery, so that they will be immune during any future pregnancies. A woman who is breastfeeding her baby can safely be vaccinated.

Women in their first few months of pregnancy who have had contact with a person who has rubella should have their blood tested for rubella infection or immunity and should be advised accordingly.

The rubella and MMR vaccines are not recommended during pregnancy, and a woman should wait one month after vaccination before she attempts to conceive.

Can infants with CRS spread the rubella virus to other persons?
Yes. Infants with CRS can spread rubella directly to other persons who are not immune to the disease. These infants can spread the rubella virus through their nose/throat discharges and urine for up to one year after birth.

What can be done to prevent the occurrence of congenital rubella syndrome?
The best way to prevent CRS is by being sure everyone gets the rubella vaccine to reduce the virus circulating in the community and reducing the risk of exposure for non-immune women. Maintaining high levels of rubella immunization in the community is critical to controlling the spread. Children need to be vaccinated with rubella-containing vaccine (usually MMR) at appropriate ages and women of childbearing age should have their immunity determined and receive rubella vaccine if needed. Infected children should not attend school during their infectious period.

Does past infection with rubella make a person immune?
Yes. Immunity acquired after contracting the disease is usually permanent. Immunity to rubella does not protect a person from measles, or vice versa.

Is the MMR vaccine safe?
The MMR vaccine is safe and effective and generally has very few side effects. Mild reactions such as fever, redness or swelling at the injection site are the most commonly reported symptoms.

Following media publicity surrounding a report published in 1998 claiming a link between MMR vaccination and autism, public confidence in some countries has been undermined. Findings of subsequent studies have shown no link between vaccination and autism.

Are there any plans to eliminate congenital rubella syndrome?
In its strategy plan to eliminate measles in the European region by 2010, the World Health Organization Regional Office for Europe is also including an accelerated control of rubella and congenital rubella syndrome. This includes the achievement and maintenance of very high routine immunisation coverage and strengthening surveillance systems.

Note: The information presented by this fact sheet is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals.