Congenital Rubella Syndrome: A Continuing Problem

Abstract

The 1964-1965 rubella pandemic resulted in approximately 20,000 malformed infants and 30,000 stillbirths in the United States, with an estimated economic impact of approximately $1.5 billion. 1 The opportunity to prevent similar tragedies was provided when rubella vaccine was licensed in 1969. Initial control efforts in the United States were aimed at preschool and young school-aged children to decrease the overall number of rubella cases and, consequently, the chances of exposing a susceptible pregnant female. Vaccination of susceptible postpubertal females was given lower priority. Implementation of this strategy has resulted in an interruption of the characteristic epidemics of rubella at six- to nine-year intervals, a marked reduction in the overall incidence of rubella, and prevention of epidemics of congenital rubella syndrome (CRS). 2 The major impact has been on young school-aged children, among whom rubella incidence decreased 89% between 1966-1968 and 1975-1977. Unfortunately, less progress has been made in controlling