Rubella (German measles) is a viral infection disease that typically causes mild illness. However, infection during pregnancy, particularly in the first trimester, can lead to miscarriage, stillbirth, or serious birth defects associated with congenital rubella syndrome. While rubella is now rare in Australia due to high vaccination coverage, cases and outbreaks continue to occur internationally. 

People at increased risk of infection include:

• people who have not received two doses of rubella-containing vaccine or do not have serological evidence of immunity to rubella
• travellers to or from areas where rubella remains endemic or where outbreaks are occurring
• people who work in healthcare and childcare settings.

Pregnant women who are not immune to rubella and their babies are at increased risk of serious complications from rubella. Risk is greatest when infection occurs early in pregnancy.

Medical practitioners and pathology services must notify rubella and congenital rubella upon initial diagnosis (suspected or confirmed) to the Department of Health immediately (as soon as practicable and within 24 hours) by calling 1300 651 160 (24/7). Pathology services must also provide written notification within 5 working days.

Recommendations for medical practioners:

• Notify rubella and congenital rubella upon initial diagnosis (suspected or confirmed) to the Department of Health immediately (as soon as practicable and within 24 hours) by calling 1300 651 160 (24/7) and connecting to the appropriate Local Public Health Unit.
• Consider rubella in patients with compatible illness and relevant epidemiological risk factors such as:
• contact with a person with rubella
• recent travel to, or contact with travellers from, a country or region where rubella is circulating
• maternal rubella infection during pregnancy (for suspected congenital rubella).
• Ask about pregnancy status and possible exposure of pregnant contacts.
• Arrange testing and seek advice from an infectious disease’s specialist and/or Local Public Health Unit.
• Advise cases to avoid contact with others, particularly pregnant women, while infectious (or until test results are known for suspected cases).
• Advise cases to not attend school, childcare or work until 7 days after rash onset or until fully recovered, whichever is longer.
• Refer pregnant patients with suspected rubella, or pregnant contacts exposed to rubella, urgently for clinical assessment and management. This may include urgent serological testing and post-exposure prophylaxis for pregnant contacts.

Recommendations for pathology services:

• Notify rubella and congenital rubella to the Department of Health immediately (as soon as practicable and within 24 hours) when the test result indicates the person has or may have rubella by calling 1300 651 160 (24/7) and connecting to the appropriate Local Public Health Unit.
• Provide written notification within 5 working days.