For those who are not immune to rubella

Rubella (German measles) is an infection caused by the rubella virus. It is usually a mild illness that causes a rash, sore throat and swollen glands. It occurs most commonly in young children, but can affect anyone. It is usually mild. However, if you are pregnant and catch rubella, it can cause serious damage to your unborn child.

If you have not already been vaccinated against rubella, or if you have not had a past infection, you will be at higher risk of catching it. You are normally considered at risk if your antibody levels against rubella are less than 1:16 IU.

●What if a pregnant women catches rubella?
If a pregnant woman catches rubella during her first 20 weeks of pregnancy, it can cause birth defects in her unborn child such as cataracts, glaucoma, deafness, heart defects (heart abnormalities) etc. This is called congenital rubella syndrome (CRS) and it is transmitted to the baby through the placenta. The risk to your baby is 100% during weeks 4-6 of pregnancy, 80% during weeks 7-12, 54-56% during weeks 13-16, 6% during weeks 17-20 and no risk after the 20th week.

●Symptoms of rubella (in adults)
Patients may develop a rash, a fever, swollen glands, joints pain etc. Symptoms tend to be more severe in adults than in children. In rare cases, severe complications such as encephalitis or inflammation of the brain (approximately 1 in 6000); thrombocytopenic purpura, a condition where the blood doesn’t clot properly (approximately 1 in 3000) or hemolytic anemia (a type of anemia) might occur.
There is currently no treatment for rubella, once you have been infected. Therefore, treatment focuses on providing relief from the symptoms of rubella as the body fights the infection. This is called supportive care. Supportive care may include fluids, rest, and medications (such as acetaminophen or ibuprofen) to control the fever or pain.
If you have these symptoms or if you think you may have been exposed to rubella, contact your doctor/midwife right away.

You must be careful not to get infected with rubella if you are pregnant.
-Keep away from crowds and places with many children.
-If members of your family have never been vaccinated against rubella, ask them to get vaccinated.

●After giving birth
We strongly recommend that you get vaccinated for any future pregnancies you may have. It will also reduce the risk of your spreading rubella. The earlier the better. You can be vaccinated against rubella while you are still in hospital after giving birth. It will cost 6300 yen. This is not covered by your health insurance.

※If your antibody titer is 1:16 IU, the efficacy of vaccination is reported to be approximately 82 % as your antibody levels might decrease after being vaccinated before your next pregnancy. However, if they are 1:8 IU or less, vaccine efficacy is reported to be over 95 %.

●Other important information
-You cannot receive the rubella vaccination after becoming pregnant.
– Adults who receive the rubella vaccine are more likely to develop swelling of the joints compared to children. In extremely rare cases, there is the risk of thrombocytopenic purpura, which is a problem where the blood doesn’t clot properly (approximately 1 in one million). However, the risk of catching rubella is far greater and more severe.
-You can breast-feed your baby as usual after vaccination.
– You should avoid pregnancy for two months after vaccination.

Refer to free Rubella antibody test for preventing congenital rubella syndrome.
Maternity check-up calendar

Kaori Nagashima M.D.