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Australia eliminated rubella – but that doesn’t mean it can’t come back

Australia eliminated rubella – but that doesn’t mean it can’t come back

The World Health Organization (WHO) has officially declared the world to have eliminated rubella.

German measles, also known as German measles, is a contagious viral disease. Symptoms in babies are usually mild – fever, rash, sore throat – but infection during pregnancy can be devastating to unborn babies.

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An infection in the first trimester of pregnancy is likely to result in a miscarriage or a birth defect, known as congenital rubella syndrome (CRS), in the developing fetus.

Children born with CRS can have deafness, blindness, cataracts, intellectual disabilities, and heart defects.

Australian discovery

In the 1940s, world-renowned ophthalmologist Sir Norman McAllister Gregg first described the relationship between maternal rubella and cataracts and other birth defects in infants.

This led to the development of the rubella vaccine in the 1960s and exciting prospects for eradicating the disease.

Before the start of rubella vaccination, large outbreaks were recorded. There were more than 3,000 documented cases of rubella in 1963-1964.

Our first immunization programme, launched in 1971 with the aim of preventing infection during pregnancy and subsequent exposure to CRS, targeted only female students.

But because most infections occurred in childhood and men were not vaccinated, the rubella virus continued to spread, causing outbreaks. In the early 1990s, there were still an average of 4,000 cases per year.

Achieving the eradication of German measles

Eradication is defined as “the reduction of the incidence rate to zero due to a specific factor in a specified geographical area”. This means that there may be some circulation (also known as endemicity) of the virus in that area.

In 2014, the world’s measles eradication was verified. We have been able to complement our rubella eradication efforts by switching from the schoolgirl rubella program to a single-dose childhood measles, mumps, and rubella (MMR) vaccine. Girls and boys 12 months in 1989.

Since 1993, a second dose has been added to catch those who have missed the first dose or who are not fully protected.

World made a concerted effort to boost coverage of the MMR vaccine in 1998 by conducting a mass vaccination campaign at the school.

Since then, coverage has continued to grow, with more than 94 percent of children vaccinated with the measles, mumps and rubella (MMR) vaccine. A recent study estimated that nearly 92 percent of 49-year-olds are protected from rubella.

The effect is clear: in 2012-2017, there were only four cases of CRS and fewer than 40 cases of rubella were reported each year. This is a far cry from the thousands reported in the pre-vaccination era.

Check the global rubella eradication status

As required for measles, the scientist had to submit a detailed report to the WHO, providing evidence of rubella eradication. This included evidence that the majority of the population is immunized against rubella and that vaccine coverage is high. It was also important to show a low incidence of rubella and CRS.

This evidence supports a sensitive surveillance system to detect and respond to cases when they occur and to check whether the rubella virus strain is circulating locally or imported from abroad. In the past three years, cases of rubella have been strains from abroad and not the virus that is spreading globally.

Elimination does not mean eradication

Eradication only occurs when all countries of the world have eradicated the disease. The only human disease that was eradicated was smallpox in 1979.

The Americas region, and five countries in our region, have been verified to eliminate rubella and CRS. But it is widespread in many countries.

Not all countries have introduced rubella vaccination. As of December 2016, only 152 out of 194 countries have introduced the vaccination.

Even in some countries with vaccination programmes, coverage is so low that large outbreaks still occur.

There is no room for complacency

We need to maintain high coverage with our routine vaccination programs to ensure eradication, as rubella is still likely to be imported from other countries.

Travelers should have two vaccinations against measles, mumps and rubella before traveling abroad. Every effort should be made to ensure that new arrivals in the world receive vaccinations, especially women of childbearing age.

Finally, to eliminate rubella, we need the support of other countries to strengthen control efforts in our region, and globally.

 

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