Rubella susceptibility among pregnant women in North London, 1996-1999.

BACKGROUND Rubella infection and congenital rubella are currently rare in the United Kingdom, although sporadic cases occur, often associated with travel abroad. Uptake of the combined measles, mumps and rubella (MMR) vaccine has declined in recent years, and there is a danger that rubella infection could start to circulate again, with serious implications for susceptible pregnant women. This could be a particular problem in communities where there are relatively high rubella susceptibility rates because of either poor vaccine uptake over several years or the presence of significant numbers of recent immigrants from countries without routine rubella vaccination programmes. METHODS Routinely collected data on rubella susceptibility in pregnant women in the former North West Thames region were available for 1996-1999. Associations between year of delivery, maternal age, parity and ethnic group, and rubella susceptibility were explored. RESULTS Overall rubella susceptibility declined significantly from 2.6 per cent to 2.4 per cent between 1996 and 1999. Whereas less than 2 per cent of British-born women were susceptible, overall susceptibility for other women was about 5 per cent. African and Asian women had particularly high susceptibility rates, and patterns of susceptibility by age and parity varied across ethnic groups. CONCLUSIONS If rubella were to re-establish itself in the United Kingdom, women who had come to Britain in later childhood or adult life would be at higher risk of acquiring infection in pregnancy than indigenous women. Appropriate local and national strategies should be devised to ensure that all such women are offered rubella vaccination at the earliest opportunity.