Rubella - Can it be
Eradicated?
During the 1998 year, there were 345 cases of rubella reported nationwide.
This is double the number of cases reported during any of the past six years.
When compared to the 1950’s, this is a very small number, but this “mild”
disease is still quite capable of doing serious damage to a fetus. This fetal
damage is commonly known as Congenital Rubella Syndrome (CRS).
For most adults, rubella (sometimes referred to as German measles) is usually a
mild disease with a rash and a fever. However, for a woman who contracts the
disease in the early months of a pregnancy, rubella frequently causes death or
major damage to her unborn child.
This damage can be mental retardation, blindness, deafness, and/or other serious
outcomes.
The last major epidemic of rubella swept across this country during 1963 and
1964, and left in its wake over 20,000 permanently damaged infants. During the
mid-sixties, a rubella vaccine was approved for use in the U.S. which was highly
effective and well tolerated by children.
After implementation of a mandatory vaccine program, the numbers of annually
reported cases of this highly contagious viral disease dropped over 99.5%.
Today, the eradication of rubella is of serious concern to the professionals
that study diseases -- epidemiologists. For over 30 years, this very effective,
safe, vaccine has been available and should be capable of totally eradicating
this disease, yet cases of rubella continue to occur.
Rubella has long been considered a childhood disease, but is now striking mostly
teenagers and adults. Current policy in the U.S. is “to vaccinate all infants
against rubella using measles-mumps-rubella vaccine, and then to revaccinate
either at school entry or at adolescence”. According to the epidemiologists
studying this issue, many of those persons who are currently catching rubella
within the borders of the U.S. have been born in foreign countries which have
little or no vaccination program. Unvaccinated persons arrive in the U.S. mainly
from Latin American countries.
The outbreaks that are occurring in the U.S. today are often within Latino
communities – among young unvaccinated men. When rubella outbreaks occur in
adults, CRS follows. A nationwide review of CRS from 1985 to 1996 reported that
44% of cases were in Latino infants.
Armed with this information and keeping in mind that rubella vaccine is
inexpensive and widely available, researchers consider that eradication of
rubella and CRS is feasible.
The researchers recommend that efforts be expanded in the areas of routine
postpartum vaccination of susceptible women, in giving attention to adolescents
of both sexes, and in making sure that young men are included in rubella
vaccination strategies.