A panel of global health officials on Wednesday announced that rubella, a disease that can have debilitating effects on unborn children, has been eradicated from the Americas.
Rubella in the Americas
Rubella, also known as German measles, once ran rampant across the Western Hemisphere. During a 1964-1965 outbreak in the United States, 11,000 fetuses were miscarried, died in the womb, or were terminated, while 20,000 babies were born with birth defects. In children and adults, rubella typically produces just a mild rash and fever; it can be prevented by the measles, mumps, and rubella—or MMR—vaccine.
Before determining that rubella had been eliminated in the Americas, public health authorities combed through 165 million records and conducted 1.3 million checks to see if communities had rubella cases. In addition, CDC tested all recent cases to confirm that they developed from imported strains of the virus, rather than domestic ones.
Officials declare the disease eliminated because it found no cases of rubella that originated in North or South America in at least five years. The disease was eradicated in the United States in 2005, and the last native case in the Americas was confirmed in Argentina in 2009, but it took six years to declare the disease totally eradicated because of rubella's hard-to-detect symptoms.
"The elimination of rubella from the Americas is a historic achievement that reflects the collective will of our region's countries to work together to achieve ambitious public health milestones," says Carissa Etienne, director of the Pan American Health Organization, which made the announcement jointly with CDC, UNICEF, and the United Nations Foundation. She adds, "Ours was the first region to eradicate smallpox, the first to eliminate polio, and now the first to eliminate rubella. All four achievements prove the value of immunization and how important it is to make vaccines available even to the remotest corners of our hemisphere."
Paul Offit of the Children's Hospital of Philadelphia says, "There's no person-to-person spread in American children," "it doesn't mean the disease doesn't come into the country."
Officials: It's not over
Despite progress in the Americas, rubella remains a major global issue. Each year, 120,000 children are born with birth defects—such as blindness from cataracts or permanent brain damage—that are attributed to the disease.
The European region—which includes Russia, and Central Asia—hopes to follow in the Americas' footsteps and eliminate the disease soon, according to the New York Times. Meanwhile, other regions are far enough along to set eradication target dates.
Nonetheless, Susan Reef, rubella team lead in CDC's global immunization division, says the disease will not be eliminated worldwide before 2020.
More broadly, Etienne notes that the work to eliminate infectious diseases is not over. She says, "Although it has taken some 15 years, the fight against rubella has paid off," adding, "Now, with rubella under our belt, we need to roll up our sleeves and finish the job of eliminating measles, as well."
How measles spreads through U.S. communities
Smallpox was eliminated in the Americas in 1971, and later was eradicated worldwide. Polio was eliminated in 1994, but has not yet been eliminated across the globe.
Until last year, measles had been considered eliminated in the United States for more than 10 years, but new measles cases have surged due to pockets of low vaccination rates that compromise herd immunity (McNeil, New York Times, 4/29; Leonard, U.S. News & World Report, 4/29; BBC News, 4/29; Haynes, UPI, 4/29; Sifferlin, TIME, 4/29).
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