Rubella Near Elimination in the United States
Measles no longer endemic in the United States
The United States has nearly eliminated rubella, a disease that can cause miscarriage, still birth and fetal abnormalities such as deafness, cataracts, heart defects and mental retardation. In 2001, only 19 cases of rubella were provisionally reported to the Centers for Disease Control and Prevention (CDC), compared to 1,401 cases a decade ago.
"Our success with rubella represents one of our greatest successes in vaccine-preventable disease reduction in 2001," said Walter A. Orenstein, M.D., director of CDC's National Immunization Program. "In 1969, the year the rubella vaccine was instituted in the U.S., there were 50,000 cases of rubella." He credited global immunization efforts, especially in Latin America, with contributing to the success of the rubella program in the United States, by diminishing the number of cases imported into the U.S. Rubella vaccines are routinely administered in 37 of the 41 countries reporting to the PanAmerican Health Organization. Orenstein addressed more than 1,700 health care professionals, scientists and researchers during the first day of the four-day 36th National Immunization Conference held in Denver, Colorado.
A rubella epidemic in the United States in 1964 resulted in 12.5 million cases of rubella infection; 2,000 cases of encephalitis; 11,250 abortions (surgical/spontaneous) and 2,100 neonatal deaths. During the epidemic, about 20,000 infants were born with congenital rubella syndrome (a pattern of fetal abnormalities that includes cataracts, hearing impairment, cardiac disease and mental retardation).
Rubella, also called German measles, is often a mild rash illness when contracted by adult males and children. Infection of a pregnant woman can be disastrous in early gestation. Up to 85 percent of infants infected in the first trimester of pregnancy will be suffer side effects ranging from cataracts to death.
Measles no longer endemic in the United States
CDC's immunization director also focused on the success made in the measles control program. "We have achieved another major success in immunization C measles is no longer endemic in the United States," said Orenstein. But he cautioned attendees at the conference that the United States remains at continuous risk from importations of the disease. "As long as measles is circulating anywhere in the world, cases of measles will be brought into the U.S. To prevent endemic transmission, maintaining high immunization coverage rates is essential in the U.S. and other countries," he said.
The majority of measles cases now seen in this country were either documented or believed to have been brought in from other countries or are linked to such cases. In 2001, there were 108 confirmed cases of measles (provisionally reported) in the United States and only 522 (provisionally reported) in the Western Hemisphere -- down from 1,760 cases in 2000. This represents more than a two-thirds reduction in the number of cases in the Americas in only one year.
A resurgence of measles cases in the United States in 1989-1991 was largely due to low vaccination coverage. During these three years, more than 50,000 measles cases, 11,000 hospitalizations and 123 deaths were reported. Measles is a highly contagious respiratory disease caused by a virus. Symptoms of measles last for about a week and include rash, high fever, cough, runny nose and red, watery eyes. More severe complications include pneumonia, encephalitis, seizures and death.
During the 36th National Immunization Conference this week, participants are exploring the latest research and policy issues related to vaccine-preventable diseases and immunization. To speak to an information specialist or to receive information materials about vaccine-preventable diseases, contact CDC's National Immunization Information Hotline at 1-800-232-2522 (English) or 1-800-232-0233 (Spanish) or visit CDC's immunization website at www.cdc.gov/nip
The Centers for Disease Control and Prevention (CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.
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