Stark Rubella Contrasts

The World Health Organization estimates that about 100,000 children each year are born with congenital rubella syndrome (CRS), a major cause of severe birth defects such as blindness, deafness, heart disease, and mental retardation. When pregnant mothers get rubella, a highly contagious otherwise-minor illness, the results for their babies can be devastating.

Most of the 100,000 victims each year are in developing nations . although the first nation to eliminate CRS was Cuba, who did it in the mid 1990s with an aggressive immunization program. On March 21, 2005, the United States formally and officially declared itself free of rubella. This is a major public health milestone. Rubella peaked in the United States in the mid 1960s when one epidemic caused an estimated 12.5 million cases of rubella in the U.S., leading to 20,000 cases of CRS which according to the CDC was responsible for ‘more than 11,600 babies born deaf, 11,250 fetal deaths, 2,100 neonatal deaths, 3,580 babies born blind and 1,800 babies born mentally retarded.’ Cases of rubella fell rapidly after the vaccine was introduced in 1969. In 1989, the CDC set a goal of eliminating rubella from the United States, and 2005 is the year of celebrating this major success. But.

New babies around the world still suffer each year. Their mothers deserve protection from this brief .cold. that may not be noticed by the pregnant women, but that can still produce permanent changes in the babies they lovingly carry.

And even though the disease was eliminated in the United States, there were 9 cases of rubella here in the previous 12 months. None of these people caught the disease in the U.S., and thanks to the vaccine, none of them spread it here because only humans get rubella.

We expect new cases like this in the U.S. every year . with many more cases in some years than others. Rubella tends to arrive in epidemics, with major epidemics every six to nine years. Epidemics still occur in many countries around the world, only a quick plane flight away. Rubella is extremely contagious. People can be contagious for up to two weeks before they have symptoms and for six days or more afterwards. Ninety to 100 percent of people who are not immune will get rubella if exposed.

Rubella is most common in the late winter and early spring (March, April, and May in the northern hemisphere) both during epidemics and in the off years. Springtime is a great time to remember each year that any woman anywhere who might possibly get pregnant should be certain by a blood test or vaccine that she is immune to rubella.

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Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

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