Which action is appropriate regarding rubella exposure when a pregnant healthcare worker is not immune?

• A. Exclude the pregnant healthcare worker from entering the room
• B. Exclude all healthcare workers regardless of immunity
• C. No restriction is needed for immune staff only
• D. Require vaccination of the entire staff before returning to work

Answer: (A)

Rubella infection during pregnancy can cause serious fetal damage, so protecting a nonimmune pregnant worker from exposure is essential. If a pregnant staff member has no immunity and there is potential rubella exposure, the safest course is to exclude her from entering the room where rubella patients are cared for or from direct care of rubella cases. This minimizes the risk of transmitting rubella to the fetus during the contagious period. Vaccination isn’t an option during pregnancy because the rubella vaccine is a live vaccine and cannot be given to someone who is pregnant. Requiring vaccination of the entire staff before returning to work isn’t appropriate for this immediate exposure scenario, and restricting only immune staff isn’t necessary since the concern focuses on protecting the nonimmune pregnant worker.