We’ve eliminated rubella so no need to screen for it in pregnancy!

Rubella has been eliminated in the UK. That’s amazing news! And has implications for pregnant women too.

When you’re pregnant, everyone wants your blood! As I watched my blood fill vial after vial after vial, my head got a bit swimmy. With Girlbug I was blissfully unaware that this was a minuscule amount compared to giving birth, with Boybug it gave me flash backs!

Several weeks later, an official looking envelope appeared on the door mat Рit contained a print out of my blood results. My iron count, blood group and rhesus status, and tests for a range of infectious diseases (the full list of tests are here).  All very normal and boring. With Boybug I got to do this twice РI moved NHS trust at 38 weeks and apparently the only way of getting my results onto their system was to test my blood again. Happy I was not.

One of those tests is rubella immunity. I remember the vaccination. I’m of the generation that had it at 15 at school – just us girls – I was a few years too old to get the MMR vaccination (measles, mumps and rubella). Even then I was aware that this was to protect our future children, a thought a million miles away from our teenage existence.

 

Baby bump
A Girlbug bump, and our blissfully unaware cat

While rubella, or German Measles, is often mild; in pregnancy it can lead to major complications for the foetus. So, we have been vaccinating since 1970. And it’s a major success story – we’ve eliminated it guys! There were 65 cases in 2012, 13 in 2013 and 1 in 2014 (data here), in the whole population, not just pregnant women.

Currently we screen for rubella immunity in pregnancy – if a woman isn’t immune, she is advised to avoid contact with cases and offered the MMR vaccine after her pregnancy, to protect in future pregnancies. However, it’s been decided that this is no longer the best policy (decision process here). Because we’ve eliminated it (wow!). Cases of rubella are now so rare, that even if a woman isn’t protected, the chance of her catching it during pregnancy are minuscule.

So from April 2016,we’re not going to screen pregnant women. We’re going to rely on the fact that rubella has been eliminated in the UK (wohoo) and that coverage for MMR is now nearly 95% (the level recommended by The World Health Organization). What it does mean, is that it’s important to keep those MMR rates up. While rubella has been eliminated in the UK, it hasn’t been eradicated globally (we’ve only managed that with smallpox), so reintroduction could occur…that and we still have measles and mumps to deal with. Many of the recent cases in pregnant women have occurred abroad – something to consider if you’re pregnant and haven’t been vaccinated.

Did I mention we’ve eliminated rubella? And that it’s amazing? From 1971-1975 there were an average of 48 children born with rubella, and 742 terminations each year. Now…there are none! And one less blood test is a good thing in my book!

I’ll drink to that! Happy Friday night!

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