When should I consider referring a patient with suspected rubella for specialist evaluation?

Consider referring a patient with suspected rubella for specialist evaluation urgently if the patient is a pregnant woman and rubella infection is confirmed or strongly suspected, especially if the pregnancy is within the first 20 weeks of gestation. In this case, contact the local Health Protection Team immediately and arrange urgent referral to obstetrics (fetal medicine) for risk assessment, counselling, and management due to the risk of congenital rubella syndrome (CRS) which is highest before 16 weeks gestation and particularly before 8–10 weeks.

For non-pregnant patients, specialist referral is generally not required unless serious complications such as haemorrhagic complications or encephalitis are suspected, in which case urgent secondary care assessment should be arranged.

Rubella is a notifiable disease and should be reported to the local Health Protection Team immediately upon clinical suspicion, regardless of referral decisions.