Factsheet about congenital rubella syndrome (CRS)

Congenital rubella is the infection of a foetus with rubella virus following the infection of the mother during pregnancy. ‘Congenital’ indicates that the foetus also becomes infected during pregnancy.

Transmission

Rubella is a mild febrile rash illness caused by rubella virus and is transmitted from person to person via droplets (the virus is present in throat secretions). It can affect anyone who is not protected. If infection in an unprotected person occurs during pregnancy, placental infection occurs and may lead to transplacental foetal infection.

Symptoms 

Symptoms are often mild, and up to 50% of infections may not present symptoms or be subclinical. However, as many as 85 out of 100 babies born to mothers who had rubella shortly before or during the first three months of pregnancy may develop health problems, so-called congenital rubella syndrome.

Complications

Rubella infection of the foetus may have severe consequences on the development of baby’s organs, which may result in birth defects or problems at a later stage in life.The type of complications may vary in nature and severity, depending on the stage of pregnancy when the infection occurred.

Complications affect 85 out of 100 babies whose mothers had rubella just before or at the beginning of the pregnancy. Complications include deafness, cataracts, heart defects, brain disorders, mental retardation, bone alterations, liver and spleen damage. Furthermore, an infant infected with rubella during pregnancy can continue to shed the virus for about a year, sometimes longer. Symptoms can appear in the infant immediately at birth and up to the age of four years. Late-onset manifestations of congenital rubella syndrome are diabetes, thyroid dysfunction, and visual or neurological abnormalities.In approximately 20% of the cases, rubella infections result in the death of the foetus.

How common is congenital rubella in the EU?

Congenital rubella is a rare disease in the EU but cases of CRS are still reported every year  according to reports from WHO.

Can congenital rubella be prevented?

Yes, by ensuring that everyone in the EU is vaccinated against rubella. In particular, women who are planning to get pregnant should be vaccinated if not vaccinated or uncertain about their vaccination history as this protects the mother as well as the foetus. Women should avoid getting pregnant during four weeks following vaccination. Other population groups – and this includes unvaccinated men – also need to be vaccinated against rubella so that they do not unknowingly pass on the disease to others.

What should I do if I don't remember getting vaccinated?

Double-check any vaccination cards or records you may have. Otherwise talk to your doctor, nurse or midwife. They can run a simple blood test to check if you are already protected against rubella. In some countries, this blood test is done as part of routine care when you are planning to become pregnant or during pregnancy.

Is rubella vaccination recommended in my country?

Please refer to the ECDC vaccine scheduler (link is external)and to your country’s recommendations for vaccinations. All countries in the EU/EEA recommend that all people should be vaccinated against rubella as part of a combination vaccine that contains also the measles and mumps antigen (MMR vaccine). Catch-up programmes are in place for those who may have missed vaccination or who are uncertain about their vaccination history. Vaccines against rubella have been in use in Europe since the 1970s. The measles, mumps and rubella (MMR) vaccine offers safe and effective protection against rubella and is the main vaccine in use in Europe. MMR vaccines used in Europe are contra-indicated during pregnancy. Your doctor, nurse or midwife will be able to advise you on when to get vaccinated.