Elimination of Rubella From the United States: A Milestone on the Road to Global Elimination

Abstract

Routine rubella vaccination was begun in the United States in 1969 with the goal of preventing congenital rubella infection. In October 2004, 35 years after initiation of the program, an independent panel of international experts was convened by the Centers for Disease Control and Prevention to assess progress toward elimination of rubella and congenital rubella syndrome (CRS). Based on available data, panel members concluded unanimously that rubella is no longer endemic in the United States. The national objective of elimination of rubella and CRS by 2010 from the United States has been attained.1 Rubella was first described as a mild exanthematous illness of childhood early in the 19th century by German physicians, resulting in the name German measles. In 1941, Sir Norman Gregg, an Australian ophthalmologist, recognized that a number of children developed cataracts after an epidemic of rubella and proposed an association between maternal rubella infection and the development of cataracts, deafness, heart disease, and mental retardation in the infant.2 In addition, Gregg is credited with introducing the concept of an intrauterine viral infection as having teratogenic potential. In 1962, rubella virus was isolated in cell culture.3,4 This was the same year as the start of a worldwide pandemic that spread to the United States in 1964-1965 and resulted in >12 million cases of rubella. This was the last rubella epidemic to occur in the United States, but it resulted in thousands of infections in pregnant women, causing … Address correspondence to H. Cody Meissner, MD, Division of Pediatric Infectious Disease, Tufts-New England Medical Center, 750 Washington St, Boston, MA 02111. E-mail: cmeissner{at}tufts-nemc.org