Tag: pregnancy

When Was the Last Case of Rubella in the United States?

While we rarely hear about rubella anymore, like most other vaccine-preventable diseases, the last case of rubella in the United States was a lot more recent than you probably imagine.

Austin recently had its first case of rubella in twenty years.

Although endemic rubella and congenital rubella syndrome were declared eliminated in 2004, like measles, we still have cases each year.

When Was the Last Case of Rubella in the United States?

To be sure, rubella is far less common that it used to be.

Remember the rubella epidemics of the 1960s, when rubella caused 2,100 neonatal deaths and 20,000 infants to be born with congenital rubella syndrome?

If natural herd immunity really works, how do you explain congenital rubella syndrome in the pre-vaccine era and in countries that don't use the rubella vaccine?
If natural herd immunity really works, how do you explain congenital rubella syndrome in the pre-vaccine era and in countries that don’t use the rubella vaccine? Why doesn’t everyone get natural immunity when they are younger and rubella is milder, avoiding the chance of getting sick when they are pregnant?

How about the rubella outbreaks in the early 1990s, when rubella caused 13 deaths and 77 cases of congenital rubella syndrome?

“Rubella is a leading cause of vaccine-preventable birth defects. Although rubella virus infection usually causes a mild febrile rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome (CRS).”

Grant et al on Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination — Worldwide, 2000–2018

One of our problems today is that most people don’t remember these epidemics and outbreaks, so they don’t understand how important it is for everyone to be vaccinated and protected.

They have no idea how fortunate they are that these diseases no longer make routine headlines.

But what happens if too many people skip or delay their vaccines?

Japan is still dealing with a large outbreak of rubella, with resulting cases of congenital rubella syndrome.

We will see more rubella and congenital rubella syndrome.

There were five cases of congenital rubella syndrome in the United States in 2017, all import related.
All five cases of congenital rubella syndrome in the United States in 2017 were import related.

While we do see some congenital rubella cases now, they are all women who were exposed to rubella outside the United States when they were pregnant.

“During 2001–2004, four CRS cases were reported to CDC; the mothers of three of the children were born outside the United States.”

Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome — United States, 1969–2004

Again, since the endemic spread of rubella was declared eliminated in 2004, cases since then are import related. People who aren’t immune get exposed to rubella when they are traveling to areas of the world where rubella is more common and return. Fortunately, since rubella isn’t as contagious as measles, these cases don’t usually cause big outbreaks.

So when was the last case of rubella and congenital rubella syndrome in the United States that wasn’t imported from outside the United States?

It was just before 2004.

Let’s get everyone vaccinated and protected before we see the next case.

More on Rubella and Congenital Rubella Syndrome

Measles Outbreaks in New Zealand

Just like other areas of the world, New Zealand has a problem with measles outbreaks. It shouldn’t be surprising then that they also have a problem with folks pushing anti-vax misinformation.

Where are the areas in New Zealand with 97% MMR vaccination rates?
Where are the areas in New Zealand with 97% MMR vaccination rates? Just askin…

Are they really seeing the most measles cases in the areas with the highest vaccination rates?

Measles Outbreaks in New Zealand

One thing is sure, there are a lot of measles cases in New Zealand.

“From 1 January 2019 to 10 October 2019 there have been 1742 confirmed cases of measles notified across New Zealand. 1416 of these confirmed cases are in the Auckland region.”

2019 NZ measles outbreak information

Do we know which parts of New Zealand have the most measles outbreaks?

We do!

Where are the cases in the measles outbreaks in New Zealand?
The case count is now up to 1742…

Of course, this doesn’t really tell you anything about why some districts have more cases than others…

Is it because they have more unvaccinated people or simply because they have a lot more people?

Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.
Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.

Wherever they live, we know that like measles outbreaks in every other part of the world, few of the folks with measles in New Zealand are known to be fully vaccinated.

And while New Zealand had eliminated home grown-cases of measles just a few years ago, it wasn’t with vaccination rates of 97%.

“For immunisation from measles, rubella and mumps two doses of the vaccine called MMR are needed. Dr McElnay said among New Zealand’s children and infants, 95 percent had had the first dose and 90 percent the full vaccine.”

NZ eliminates NZ-origin measles

Unfortunately, while they were working to get younger kids vaccinated and protected, many older kids and adults are still not vaccinated.

“However, we must remain vigilant and improve our vaccination rates because these diseases can easily spread among unimmunised people from imported cases. In New Zealand, people aged 12 to 32 years have lower vaccination rates than young children so are less likely to be protected against these diseases.”

Measles and rubella officially eliminated in New Zealand

Only about 80% of teens and young adults are fully vaccinated against measles in New Zealand!

Combined with high numbers of folks who were never vaccinated and folks who travel to other parts of the world where measles is still endemic and you have a recipe for disaster.

“While there have been no measles deaths in this outbreak, there have been five pregnant women hospitalised and two fetal losses associated with these events.”

Report investigates high hospitalisation rates for measles in Auckland region

In addition to the two unborn babies who died, there are also reports of at least three hospitalisations for encephalitis.

Two doses of the MMR vaccine is your best protection against measles.

A disaster that could easily be prevented with two doses of a vaccine that is safe, with few risks, and obviously necessary.

More on Measles in New Zealand

Where Are the Autistic Kids Who Aren’t Vaccinated?

Thanks to the anti-vaccine movement, it isn’t hard to find autistic kids who aren’t vaccinated.

Wait, what?

Where Are the Autistic Kids Who Aren’t Vaccinated?

For one thing, folks in the anti-vaccine movement do a good job scaring parents, which means that there are simply more unvaccinated kids around.

And because vaccines aren’t associated with autism, these unvaccinated kids can and do develop autism.

How do we know?

Parents in anti-vaccine groups and forums often ask…

Do you know anyone who is autistic and unvaccinated?

And invariably, the answer they get is that yes, many of them either have or know of autistic kids who are unvaccinated.

Hopefully that will eventually lead them all to understand that vaccines are not associated with autism, so that they don’t continue to leave their kids unvaccinated and at risk to get a vaccine-preventable disease.

More on Autistic Kids Who Are Unvaccinated

Did Pediatricians Ever Encourage Parents to Have Measles Parties?

While the idea of chickenpox and measles parties now seems ridiculous to most people, in the pre-vaccine era, it might not have been so strange. Since getting these diseases was inevitable, it might make some sense to try and control when your kids got sick. Did did pediatricians actually encourage parents to have measles parties?

Did Pediatricians Ever Encourage Parents to Have Measles Parties?

Some folks think they have evidence that they did!

This is not evidence for measles parties...
This is not evidence for measles parties…

Wait, did they really have measles?

As most folks know, German measles is another name for rubella or 3-day measles.
As most folks know, German measles is another name for rubella or 3-day measles.

Not exactly…

These kids had German measles – better known as rubella. Of course, that is not the same thing as measles or rubeola.

Measles vs Rubella

Why do we worry about rubella? Unlike measles, it’s not because it can make kids very sick, but rather because if a pregnant woman gets rubella, then it can be devastating for their baby.

The idea for rubella parties started in the UK in the 1950s.
The idea for rubella parties started in the UK in the 1950s.

That’s why some folks tried to get rubella when they were kids, well before they reached the age when they could become pregnant.

How did that strategy work out?

Many articles advocating for rubella parties (German measles) appeared in the 1950s and early 1960s.

Of course, those rubella parties didn’t prevent the rubella epidemics that came in 1964-65 and caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome.”

In addition to spreading rubella to pregnant women, at these parties, younger children could get exposed to other diseases that are more serious, like measles.
In addition to spreading rubella to pregnant women, at these parties, younger children could get exposed to other diseases that are more serious, like measles.

It was the rubella vaccine that was developed in 1969 that helped control and eventually eliminate rubella and congenital rubella syndrome in the United States. And eliminated all of the risks of the measles parties that some folks used to have.

More on Measles Parties