Rubella outbreak in a prenatal clinic: management and prevention

An obstetrician and two staff members developed rubella and exposed 56 susceptible pregnant women in a large prenatal and family planning clinic. Two women (3.6%) developed rubella at 27 and 38 weeks' gestation and delivered uneventfully. Sixteen hundred clinic and hospital employees were tested, with 79% of the total and 48 of 59 (81.4%) OB/GYN personnel showing prior infection and/or immunity (HAI titer greater than or equal to 1:8). Of those susceptible, all obstetrical and most other personnel were vaccinated and removed from high risk areas until immune. Our management of a rubella outbreak and recommendations on hospital and clinic policy to avoid potential health problems are discussed.