First we wiped out smallpox in North and South America. Then we rid the Americas of polio. Now, for the third time, the Americas are the first region in the world to eliminate yet another disease through vaccines: rubella. After 15 years of a widespread vaccination campaign with the MMR (measles-mumps-rubella) vaccine, the Pan American Health Organization and the World Health Organization announced yesterday that rubella no longer circulates in the Americas. The only way a person could catch it is if they are visiting another country or if it is imported into a North, Central or South American country. After the return of measles due to pockets of vaccine refusals throughout the U.S., it’s about time we heard some good news about vaccines and their ability to eliminate a previous threat to children’s lives. And in the wake of yet another study showing no link between the MMR and autism spectrum disorders, there’s a certain irony to the fact that the only clearly established cause of autism – congenital rubella syndrome – is actually prevented by the MMR vaccine. Rubella, also known as German measles, was previously among a pregnant woman’s greatest fears. Although it’s generally a mild disease in children and young adults, the virus wreaks the most damage when a pregnant woman catches it because the virus can cross the placenta to the fetus, increasing the risk for congenital rubella syndrome. Congenital rubella syndrome can cause miscarriage or stillbirth, but even the infants who survive are likely to have birth defects, heart problems, blindness, deafness, brain damage, bone and growth problems, intellectual disability or damage to the liver and spleen. The only way to prevent congenital rubella syndrome is for a pregnant woman to have immunity to the disease. The only way to develop that immunity – unless she has had rubella herself – is with the MMR vaccine, developed by Dr. Maurice Hilleman with the Merck team in 1969, just a few years after the last major rubella outbreak in the U.S. The 1964-65 epidemic resulted in 11,000 miscarriages and stillbirths and 20,000 births with congenital rubella syndrome. Outside the U.S., as recently as 1997, more than 158,000 rubella cases were reported in Latin America and the Caribbean. An estimated 16,000 to 20,000 newborns were born with congenital rubella syndrome every year in those countries before widespread vaccination. To achieve elimination, there must be no evidence of endemic transmission – an infected person in the country passing it on to another person - for at least three years. When the Expert Committee for Measles and Rubella Elimination in the Americas met last week, they concluded that no cases had occurred for five consecutive years. The last endemic case occurred in Argentina in 2009. The investigation required review of 165 million records and 1.3 million checks in communities, reported The New York Times. While definitely a success, this milestone does not mean rubella is never a threat to babies born in the Americas. Across the world, 120,000 children continue to be born with severe birth defects from the disease, including 43 cases of congenital rubella syndrome from among Japan’s 15,000 cases of rubella in 2013. If a case is imported into an area of the U.S. with low immunization coverage, it could spark another outbreak here. Source: Rubella Eliminated From The Americas, Thanks To MMR Vaccine
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