RUBELLA

Person-to-person

Rubella can spread only by person-to-person contact. This is most often caused by a so-called droplet infection. Rubella viruses are spread via droplets after coughing or sneezing, for example, and can reach the mucous membranes of the upper respiratory tract of others when inhaled.

Pregnant women who fall ill with rubella can pass the virus on to their unborn child.

Any person who is not protected by a full vaccination or who has not previously had the illness can develop rubella. As an adult, cases of rubella are often more serious. An infection is particularly dangerous for the unborn child if a pregnant woman becomes infected with rubella.

• Before visiting your doctor’s practice, inform them that you suspect that you have a rubella infection. The practice staff can then take appropriate precautions, especially as regards pregnant women.
• There is no causal treatment for rubella, only the symptoms can be alleviated.
• Sufferers should stay at home until the 7th day after the start of the rash and avoid contact with people with or without indeterminable immune protection, especially pregnant women.
• Contact persons of sufferers with inadequate or unknown vaccine protection should get missing vaccinations against rubella as soon as possible. A so-called post-exposure vaccination cannot reliably prevent the outbreak of an illness, but it can contain a further spread of it.
• Pregnant women should consult their doctor immediately after contact with a person suffering from the illness in order to coordinate the next steps. A post-exposure vaccination is not possible during pregnancy.
• The regulations set out in the German Protection against Infection Act apply in the case of rubella. People who have been found to have rubella or are suspected of having rubella are temporarily prohibited from attending or working at community facilities such as schools or nurseries. The same also applies to people with inadequate immune protection living in a household shared with a sufferer or someone suspected of being ill. Affected persons must inform the community facility about the illness.
• The doctor treating them or the responsible health authority will decide when they can start working or attending the community facility again.

Vaccination

The German Standing Committee on Vaccination (STIKO) recommends vaccination against rubella. MMR vaccines are available for this purpose, which also protect against measles and mumps, as well as MMRV vaccines, which additionally contain a component to protect against chickenpox (varicella).

• A two-stage vaccination is recommended for children: The first vaccination should be given at the age of 11 months and the second vaccination at the age of 15 months, but no earlier than 4 weeks after the first vaccination. It is practical for the first MMR vaccination to be given as part of the early screening of children (U6). The first MMR vaccination can already be given when the child is 9 months old if the child is to be admitted to a community facility before it is 11 months old. It is important to vaccinate both girls and boys to protect pregnant women against rubella.
• Unvaccinated children and adolescents should be vaccinated in a two-step procedure as soon as possible (minimum gap of 4 weeks).
• Women of child-bearing age should be vaccinated twice before they start their first pregnancy. Vaccination against rubella is no longer possible during pregnancy. There must be at least a 1-month gap between vaccination and pregnancy.
• Adults born after 1970 employed in certain fields of work should also be vaccinated twice with an MMR vaccine. This includes staff in community facilities, in the medical sector, in nursing care, in shared accommodation facilities for refugees, for example, as well as staff in technical, vocational and university institutions.

Avoid contact with affected persons if you do not have adequate immune protection.

Your local health authority can provide you with further advice. Since rubella must be reported, it has information on the latest situation and a wealth of experience in dealing with the illness.

More (specialist) information is also available online from the Robert Koch Institute (www.rki.de/roeteln).

For more information on infection control through vaccination, please visit the Federal Centre for Health Education website (www.impfen-info.de).