Rubella outbreak in Poland
Poland is experiencing a rubella outbreak. This outbreak increases the risk of rubella infection for non-immune individuals if travelling to Poland. Rubella may be re-introduced to Ireland if people with rubella come to Ireland during the time before and immediately after rash onset. Rubella infection to pregnant women can cause serious infection and complications for the unborn infant.
All people travelling to Poland (and other countries where rubella still circulates) should ensure that they are protected again rubella (either previous rubella infection or previous receipt of a rubella containing vaccine usually provides protection). The Measles-Mumps-Rubella (MMR) is the vaccine that is now used to prevent rubella.
During the period April 2013–March 2014, 30,743 cases of rubella were reported in the EU/EEA region. Poland accounted for 99% of all reported rubella cases in this time frame; 85% of these cases were either unvaccinated or had an unknown vaccination status.
The rubella outbreak in Poland started in 2013 and has mainly affected young men (15–29 years of age) although other ages and females are also affected. This outbreak reflects the history of immunisation policies – selective vaccination of adolescent girls since 1989, then universal two-dose MMR vaccination, since 2004.
People most at risk
Prior to the introduction of rubella vaccine rubella was most common among children aged four to nine years. In Europe, rubella is now no longer common in any countries except for Poland and Romania. In Ireland, no confirmed rubella cases were reported in 2013 and Ireland is now considered rubella-free, but risk of importation still exists. Pregnant women are most at risk early in their pregnancy. The risk is greatly reduced after 24 weeks of pregnancy.
How to avoid getting rubella
Vaccines against rubella have been in use in Europe since the 1970s. The MMR vaccine offers safe and effective protection against rubella and is the main vaccine in use in Europe. Unvaccinated males and females should catch up with rubella vaccination to protect unborn life. In particular, if you are planning on becoming pregnant you should talk to your doctor about checking your immunity against rubella, particularly if you were never vaccinated.
Rubella vaccination in Ireland
Rubella vaccine has been as part of routine school immunisation programme since 1971. Between 1971- 1987 only girls routinely received this vaccine. MMR vaccine was introduced in 1988 for girls and boys.
MMR vaccine is provided to all children free of charge in Ireland, as part of the routine childhood immunisation programme. MMR is also provided to non-pregnant women who are identified as being non-immune (identified through blood screening by GP or antenatal clinics).
- MMR vaccine is usually given at 12 months of age and again at 4-5 years of age.
- A primary school-based catch-up MMR vaccination programme was carried out by the HSE school immunisation services during the academic year 2013/2014.
- A MMR catch-up programme for most teenagers in secondary schools was offered in most regions during the 2012/2013 school year.
- Children/teenagers/young adults who have missed out on two doses of MMR vaccine are strongly encouraged to get this vaccine from their GP.
- Older adults who believe they are non-immune and at risk (including women) can speak with their GP and obtain vaccine.
What to do if you have rubella
Avoid contact with pregnant women if you suspect you have rubella, until six days after the start of the rash.
ECDC. Measles and Rubella Monthly Monitoring Report (April 2014)
Paradowska-Stankiewicz I, Czarkowski MP, Derrough T, Stefanoff P. Ongoing outbreak of rubella among young male adults in Poland: increased risk of congenital rubella infections. Euro Surveill. 2013;18(21):pii=20485. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20485