Rubella is an acute eruptive infectious disease caused by a RNA virus of the Rubivirus genus belonging to the Togaviridae family. It manifests itself with a rash similar to that observed in measles or scarlet fever, two diseases from which it may be clinically indistinguishable. Rubella is generally a mild disease, but can be dangerous if contracted during pregnancy, as it may cause a miscarriage, intrauterine death or severe birth defects.
In Italy, rubella is subject to compulsory notification. Doctors are required to report any suspect case of rubella to the relevant Local Health Unit within 12 hours, by telephone, fax or email.
Rubella and pregnancy: the congenital syndrome
The rubella virus can cross the placental barrier and cause embryo-foetal defects. Therefore, if contracted during pregnancy, rubella may cause a miscarriage, intrauterine death or severe defects (congenital rubella syndrome - CRS). If infection occurs shortly before conception, or during the first 8-10 weeks of pregnancy, the risk of the foetus being affected is estimated at up to 90%. If infection occurs after the 20th week, it rarely causes birth defects.
The most common and severe manifestations of congenital rubella are: eye defects, deafness, heart defects, intellectual disability and liver and spleen damage.
Italy has established a national surveillance system of congenital rubella and rubella infection in pregnancy, and since 2005, congenital rubella and rubella in pregnancy have been included among the class III infectious diseases subject to compulsory notification.