Rubella in England, Scotland and Wales.

Rubella vaccine was offered to schoolgirls in the United Kingdom (UK) from 1970, with antenatal testing and postpartum vaccination for susceptible women introduced during the 1970s. Mass vaccination with MMR of children aged 12-15 months was introduced in 1988; schoolgirl vaccination was discontinued in 1996 and replaced by a second dose of MMR for pre-school children; postpartum vaccination of susceptible women identified through antenatal testing continues. Rubella was made a notifiable disease in 1988, and is monitored through clinical and laboratory reports; data are available on rubella associated terminations and congenital rubella syndrome(CRS) births, rubella susceptibility in population subgroups, and vaccine uptake. Reported cases of CRS declined from about 50 a year 1971-75 to just over 20 a year 1986-90, and rubella associated terminations from an average of 750 to 50 a year. About 40 infants with CRS have been reported since 1991; about a third of their mothers were infected abroad, most in their country of origin (imported infections), a third were born abroad but acquired infection in the UK, and a third were UK-born. Women living in the UK who were born abroad have much higher rubella susceptibility rates than UK-born women. Although there is currently very little rubella infection circulating, uptake of MMR has dropped by over 10% since 1995. If rubella starts to circulate again, immigrant women will be at increased risk of acquiring infection in pregnancy.