Editing Rubella (section)

==Prevention==
{{Further|MMR vaccine}}
Rubella infections are prevented by active [[immunization]] programs using live attenuated virus [[vaccine]]s. Two live attenuated virus vaccines, RA 27/3 and Cendehill strains, were effective in the prevention of adult disease. However, their use in prepubertal females did not produce a significant fall in the overall incidence rate of CRS in the UK. Reductions were only achieved by immunisation of all children.<ref>{{cite journal|last1=Robertson|first1=SE|last2=Cutts|first2=FT|last3=Samuel|first3=R|last4=Diaz-Ortega|first4=JL|title=Control of rubella and congenital rubella syndrome (CRS) in developing countries, Part 2: Vaccination against rubella.|journal=Bulletin of the World Health Organization|date=1997|volume=75|issue=1|pages=69–80|pmid=9141752|pmc=2486979}}</ref>

The vaccine is now usually given as part of the [[MMR vaccine]]. The [[WHO]] recommends the first dose be given at 12 to 18 months of age with a second dose at 36 months. Pregnant women are usually tested for immunity to rubella early on. Women found to be susceptible are not vaccinated until after the baby is born because the vaccine contains live virus.<ref name="pmid9639369">{{cite journal|vauthors=Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L|title=Measles, mumps, and rubella—vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP)|journal=MMWR Recomm Rep|volume=47|issue=RR-8|pages=1–57|year=1998|pmid=9639369|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00053391.htm|url-status=live|archive-url=https://web.archive.org/web/20090918215818/http://www.cdc.gov/MMWR/preview/MMWRhtml/00053391.htm|archive-date=2009-09-18}}</ref>

The immunisation program has been quite successful. [[Cuba]] declared the disease eliminated in the 1990s, and in 2004 the [[Centers for Disease Control and Prevention]] announced that both the congenital and acquired forms of rubella had been eliminated from the [[United States]].<ref>{{cite journal  |vauthors=Dayan GH, Castillo-Solórzano C, Nava M, et al. |title=Efforts at rubella elimination in the United States: the impact of hemispheric rubella control |volume=43 |journal=Clin. Infect. Dis. |issue=Suppl 3 |pages=S158–63 |year=2006 |pmid=16998776 |doi=10.1086/505949|doi-access=free }}</ref><ref>{{cite journal |title=Elimination of rubella and congenital rubella syndrome—United States, 1969–2004 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a5.htm |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=54 |issue=11 |pages=279–82 |year=2005 |pmid=15788995 |author1=Centers for Disease Control and Prevention (CDC) |url-status=live |archive-url=https://web.archive.org/web/20071001115001/http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5411a5.htm |archive-date=2007-10-01 }}</ref> The World Health Organization declared Australia rubella free in October 2018.<ref>{{cite news |last1=Davey |first1=Melissa |title=Rubella's elimination from Australia 'shows vaccinations work' |url=https://www.theguardian.com/australia-news/2018/oct/31/rubellas-elimination-from-australia-shows-vaccinations-work |access-date=31 October 2018 |work=the Guardian |date=31 October 2018 |language=en |archive-date=31 October 2018 |archive-url=https://web.archive.org/web/20181031003639/https://www.theguardian.com/australia-news/2018/oct/31/rubellas-elimination-from-australia-shows-vaccinations-work |url-status=live }}</ref>

Screening for rubella susceptibility by history of vaccination or by [[serology]] is recommended in the United States for all women of childbearing age at their first [[preconception counseling]] visit to reduce incidence of [[congenital rubella syndrome]] (CRS).<ref name=icsi2010>[http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html Health Care Guideline: Routine Prenatal Care. Fourteenth Edition.] {{webarchive|url=https://web.archive.org/web/20120624053201/http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html |date=2012-06-24 }} By the Institute for Clinical Systems Improvement July 2010.</ref> It is recommended that all susceptible non-pregnant women of childbearing age should be offered rubella vaccination.<ref name=icsi2010/> Due to concerns about possible teratogenicity, use of [[MMR vaccine]] is not recommended during pregnancy.<ref name=icsi2010/> Instead, susceptible pregnant women should be vaccinated as soon as possible in the [[postpartum period]].<ref name=icsi2010/>

In susceptible people [[Immunization|passive immunization]], in the form of [[Polyclonal antibodies|polyclonal immunoglobulins]], appears effective up to the fifth day post-exposure.<ref name="rubella passive">{{cite journal |last1=Young |first1=Megan K |last2=Cripps |first2=Allan W |last3=Nimmo |first3=Graeme R |last4=van Driel |first4=Mieke L |title=Post-exposure passive immunisation for preventing rubella and congenital rubella syndrome |journal=Cochrane Database of Systematic Reviews |date=9 September 2015 |volume=2015 |issue=9 |pages=2 |doi=10.1002/14651858.CD010586.pub2|pmid=26350479 |pmc=8761358 |hdl=10072/99129 |hdl-access=free }}</ref>