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US Eliminates Rubella, a Major Source of Birth Defects

The United States has eliminated the rubella virus, or German measles, a major source of birth defects. The rest of the Western hemisphere is making good progress against the disease, but that global eradication is not in sight.

The United States is the second country to eliminate rubella after Cuba reported its last case in 1995. The head of the U.S. government's disease tracking agency, Julie Gerberding of the Centers for Disease Control, says an illness that once harmed tens of thousands of infants is no longer a major health threat to the nation. "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," she said.

Rubella's affects are mild in children and adults. It is serious only in the first few months of pregnancy when there is good chance it will infect the fetus and cause miscarriage, still birth, or a range of birth defects, including blindness, deafness, mental retardation, or heart malformations.

A U.S. rubella epidemic in the late 1960s caused more than 12 million cases, leading to more than 30,000 fetal and newborn deaths or instances of birth defects.

Dr. Gerberding credits the country's success against the virus to widespread inoculation with a rubella vaccine introduced in 1969. Ninety-three percent of American children under age two receive it, combined with a measles and mumps vaccine.

But the health agency chief points out that elimination is not the same as eradication. It means only that there are no more native U.S. cases of rubella, the last of which occurred in 2000. Nine cases still arrived from abroad last year. "The goal in the United States ultimately is to have all children vaccinated effectively against rubella and the other vaccine-preventable childhood illnesses because we are at constant risk for reintroduction of the virus from other parts of the world. We cannot afford to relax our emphasis on immunization now," she said.

The World Health Organization estimates that 100,000 rubella cases occur in developing countries each year. Compared to other regions, the situation is good in Central and South America. Member states of WHO's regional branch, the Pan American Health Organization, committed in 2003 to eliminating the virus. There were only 1,600 rubella cases throughout the Western hemisphere last year, down from an annual high of 100,000.

The Organization's director, Mirta Roses Periago, says the decline has an important economic impact. "This is also a very important instrument for poverty reduction in our region, to keep the equity in immunization and to prevent families from having more pain and deaths and disabilities that will impair their possibility of success of development, of improvement of their conditions," he said.

But the head of the U.S. government's immunization program, Steve Cochi, says the rest of the world will continue to lag behind the Western hemisphere in the anti-rubella campaign for some time to come. He says total rubella eradication is a long term goal, after other diseases are conquered.

"Right now, the world needs to focus its resources on completing polio eradication and the already existing initiative to reduce measles deaths worldwide by the end of this year, as well as the many other global immunization goals that we have. That can be taken up, I think, in due time, but we are still a ways away from that," he said.

The World Health Organization says that only 58 percent of the nations and territories of the globe currently use the rubella vaccine.