U.S. Declares Rubella Eliminated

'German Measles' No Longer a Health Threat, Officials Say

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March 21, 2005 -- U.S. health officials on Monday officially declared rubella eliminated within U.S. borders.

The success of the vaccination program is credited with the reduction in the disease that once caused miscarriage, still birth and birth defects such as deafness, cataracts, heart defects, and mental retardation.

Officials say that while rubella is no longer a significant health threat in the U.S., they warned that the virus that causes it has yet to be eradicated from the Western Hemisphere. They announced no changes in the recommendations for immunizations for children and women.

Officials hailed the announcement as a major achievement of immunization programs that drastically decreased the number of rubella cases after a rubella vaccine was introduced in 1969.

Major Milestone

"This is a major milestone on the path of eliminating rubella from the rest of the world,' says Julie M. Gerberding, director of the Centers for Disease Control and Prevention.

Rubella, also known as German measles, is not usually dangerous in adults and older children and can cause a mild illness and rash. Pregnant women who contract rubella during the first trimester of pregnancy have up to an 85% risk of passing the disease onto her developing child. Infants infected in the first trimester of pregnancy suffer side effects ranging from cataracts to death.

Congenital rubella was responsible for more than 11,000 infant deaths from 1962 to 1965, according to the CDC.

The U.S. saw about 1,000 rubella cases in 1982 but saw just nine in 2004, all in women who had contracted the virus in foreign countries before entering the country. The U.S. has not reported a homegrown case of rubella since 2000, according to the agency.

Rubella vaccinations are now included in a combination measles, mumps, and rubella (MMR) vaccine.

MMR is given as a series of two doses at 12 to 15 months of age and at 4 to 6 years of age. The vaccine is also recommended for adolescents and women of childbearing age who do not already have immunity. However, women should avoid getting pregnant for four weeks after getting the MMR.


Some 1,600 rubella cases were reported in the Western Hemisphere in 2004, and health authorities are attempting to step up campaigns to spread vaccination to more nations, especially in the Caribbean, says Mirta Roses Periago, MD, director of the Pan American Health Organization.

Officials say that rubella vaccination will continue in the U.S. because international travel allows unsuspected cases to enter the country and expose susceptible individuals.

"This is the time when we want to do even more the strengthen vaccination, not less," Gerberding says.

Cuba was the first nation to achieve elimination of rubella, declaring an end in 1989 to serious birth defects known as congenital rubella syndrome (CRS). Cuba declared its last case of transmitted rubella in 1995.

U.S. officials, frequently battling disease spreads -- and sometimes public criticism over vaccine safety and distribution problems -- seemed elated by the news of a public health success.

"When in my life did I ever think I'd be able to make an announcement like that," Gerberding said to a fellow CDC official after briefing reporters.

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SOURCES: Julie M. Gerberding, MD, director, CDC. Mirta Roses Periago, MD, director, Pan American Health Organization. Morbidity and Mortality Weekly Report, CDC, March 21, 2005.
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