Rubella eliminated from the United States, CDC says

April 2005

WASHINGTON – Rubella and congenital rubella syndrome transmission has been eliminated in the United States, according to the CDC.

“This is a major milestone in the path toward eliminating rubella in other parts of the world including the Western hemisphere and other regions that have committed to this very, very important health goal,” said Julie Gerberding, MD, MPH, director of the CDC.

Prior to the license of the first rubella vaccine in 1969, there were 57,686 cases in the United States. Last year, there were nine reported cases of rubella, but they were all imported cases from other countries. Gerberding said recent rubella and CRS cases in the United States have been in mothers infected in their country of origin or their children.

The United States is not the first country to eliminate rubella. Cuba eliminated it in the 1990s, Gerberding said.

She made her remarks during a press conference on the first day of the National Immunization Conference, held here, on March 21.

A U.S. success

A panel of experts convened in October 2004 said the available data supported that rubella had been eliminated in the United States.

They considered data that showed there were fewer than 25 cases of rubella reported each year since 2001, and immunization and immunity rates are above 90%.

Rubella is still endemic in parts of the world, however.

“The story is not done yet,” Gerberding said. “There are still parts of the world where immunization is not common or not common enough to prevent children from developing congenital rubella syndrome. And so in this country while we can celebrate this milestone we also have to remain vigilant, because as we say in public health, our network is only as strong as the weakest link and as long as there’s rubella anywhere in the world, there could be rubella in our children too.”

Although the disease has been eliminated, Gerberding cautioned that now, more than ever, vaccination rates among schoolchildren should be emphasized and women of childbearing age should continue to receive vaccine, especially those born in other countries.

Rubella is typically a mild illness, but is severe in pregnant women, causing CRS, which causes birth defects of unborn children. Rubella was sometimes called the three-day measles, soft measles or German measles.

Between 1962 and 1965, there were 12.5 million cases of disease in the United States, costing an estimated $1.5 billion and killing 11,250 unborn children, 2,100 neonates and 20,000 infants who were born with CRS, the CDC said in an early release Morbidity and Mortality Weekly Report article.

In 2003, the ministers of health of the Americas declared their commitment to eliminating rubella worldwide.

For more information:

• CDC. Elimination of rubella and congenital rubella syndrome – United States, 1969-2000. MMWR early release. 2005;54:1-4.