The widespread use of rubella vaccine in the United States has dramatically decreased the number of rubella cases and has prevented epidemics. Nevertheless, outbreaks of rubella continue to occur in medical facilities and have become important in the transmission of the disease. Control of outbreaks requires isolation of infectious patients, assignment of immune staff only to infectious patients, exclusion from work of infectious personnel, special follow-up of pregnant women and exposed persons, and the rapid vaccination of susceptible staff. Implementation of hospital rubella prevention programs is preferable to controlling an outbreak. The vaccination of all susceptible personnel provides the opportunity for preventing rubella outbreaks, disruption of hospital services, and fetal rubella infection.