Rubella (German Measles) was declared eliminated from the United States in 2004. With the last case occurring in Argentina in 2009, the World Health Organization (WHO) today says rubella has joined smallpox (1971) and polio (1994) as the third vaccine-preventable disease to be eradicated from the Americas (North, South, and Central America).

As we noted on The PediaBlog in February (“Guide To Adult Vaccines – 3”), German measles is a very mild infection for those who even get symptoms (half of all cases are asymptomatic!):

German Measles is mild enough if children are unlucky enough to get it: A low-grade fever, and a rash that begins on the face and spreads to the rest of the body — all coming and going within just a few days. (Rubella is also referred to as “Three-Day Measles.”) Some young women complain of aching joints during the brief illness. Half of infected persons remain asymptomatic; they have no symptoms but can still spread the infection to others. This presents a terrible problem if those “other” persons are pregnant.


What we’re trying to prevent by vaccinating all children against rubella is Congenital Rubella Syndrome, where a pregnant woman with no natural or vaccine-induced immunity becomes infected with the virus during her first two trimesters. The effects on a baby born with Congenital Rubella Syndrome are indiscriminate and devastating. The classic triad of Congenital Rubella Syndrome is comprised of deafness (sensorineural), eye disorders (cataracts, retinopathy, small eyes), and congenital heart disease. Practically every organ in the body can be affected, however, causing severe rashes at birth (“blueberry muffin baby”) and cognitive delays and disabilities later on. (While the MMR vaccine does not cause autism, a prenatal infection with rubella can leave a child autistic.)



Though immunization policies established by the CDC and WHO, and endorsed by the AAP and your pediatricians, have led to rubella’s eradication in the Americas, the world is a small place — imported German measles is just a plane ride away. Until it is eliminated worldwide, the CDC’s recommendation for childhood immunization and surveillance during pregnancy will remain:

For women of childbearing age, regardless of birth year, rubella immunity should be determined. If there is no evidence of immunity, women who are not pregnant should be vaccinated. Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health care facility.