RUBELLA is no longer a major public health threat in the United States, thanks to years of immunization efforts aimed at wiping out the disease, which can cause serious birth defects, including deafness and blindness.

"The elimination of rubella in the United States is a tremendous step in protecting the health and well-being of pregnant women and infants," said Julie Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention. "A disease that once seriously harmed tens of thousands of infants is no longer a major health threat, thanks to a safe and effective vaccine and effective immunization programs across this country."

Gerberding made the remarks during the National Immunization Conference in Washington, D.C., in late March, where she also warned public health advocates not to rest on their laurels when it comes to rubella.

"We should take pride in this accomplishment and also recognize that we must maintain our vigilance or we can see a resurgence of the disease," Gerberding said.

About 93 percent of U.S. children younger than age 2 are vaccinated against measles, mumps and rubella, according to the CDC's National Immunization Survey. By the time they enter school, more than 95 percent of the nation's children have received the measles, mumps and rubella vaccine.

"The importance of continuing vaccination cannot be emphasized enough," said Steve Cochi, MD, MPH, acting director of CDC's National Immunization Program. "Cases of rubella continue to be brought into the country by bordering travelers and because of bordering countries where the disease is active."

A rubella epidemic in the United States from 1964 to i965 -- before rubella immunization was routinely used -- caused about 20,000 cases of congenital rubella syndrome and 12.5 million cases of rubella. Of the babies born with the syndrome, more than 11,600 were deaf, 3,850 were blind and 1,800 were mentally retarded. The syndrome also was linked to 2,100 neonatal deaths during the epidemic.

Following rubella vaccine licensure in 1969, rubella incidence fell rapidly from a high of almost 58,000 cases that year to fewer than 1,000 yearly cases by 1983.

CDC established a rubella elimination goal in 1989 even as public health officials recorded a resurgence of the disease during a measles epidemic from 1989-1991. In 2001, for the first time in history, fewer than 100 rubella cases were reported in the United States. In 2004, nine rubella cases were reported nationwide.

Since the mid-1990s, U.S. public health officials have worked closely with the Pan American Health Organization and Mexican officials to improve rubella control in the Americas. Those efforts have resulted in dramatic reductions of rubella in many nations of the Americas, according to CDC officials. In September 2003, ministers of health from all countries in the Americas vowed to eliminate rubella and congenital rubella syndrome by 2010.

Last fall, an independent panel with internationally recognized experts concluded that rubella virus is no longer endemic in the United States.

Last updated Jan 4/07