Rubella (German Measles)
What is Rubella?
Rubella is also called German measles because the disease was first described by German physicians in the mid-18th century. While the disease is usually mild in children and adults, up to 90 percent of infants born to mothers infected with rubella during the first trimester of pregnancy will develop Congenital Rubella Syndrome (CRS), resulting in heart defects, cataracts, mental retardation and/or deafness in the newborn child. It can also cause premature birth, low birth weight, neonatal thrombocytopenia (an abnormal drop in the number of blood cells involved in forming blood clots), anemia and hepatitis.
Before the rubella vaccine was introduced in 1969, widespread outbreaks usually occurred every six to nine years in the United States, mostly affecting children in the five-to-nine year age group. Between 1962 and 1965, rubella infections during pregnancy were estimated to have caused 30,000 still births and 20,000 children to be born impaired or disabled.
Due to the widespread, routine immunization only 18 cases of rubella and one case of CRS were reported in 2002; in 2004 the Centers for Disease Control and Prevention (CDC) announced that both the congenital and acquired forms of rubella had been eliminated from the United States. We continue to vaccinate to prevent the possibility of rubella being imported from countries where it is still common.
The MMR vaccine is the currently recommended vaccine to protect against rubella. For children, two doses of the vaccine are needed. The first dose is scheduled to be given between 12-15 months of age and the second dose between 4 and 6 years of age. The catch up schedule is followed for children who miss either or both of the doses.
Adult women of childbearing age should have their immunity to rubella determined and be vaccinated if they are not yet pregnant and there is no evidence of immunity. If they are pregnant then they should be immediately vaccinated after the conclusion of the pregnancy following the Adult Schedule.