Sunday, April 28, 2013

Rubella virus- Vaccinate your kids, Vaccinate your wife!

Rubella- an old enemy        
            Rubella virus, also known as German measles, is an acute viral infection that causes a rash and fever.  Typically, there are no major complications associated with rubella, as the disease lasts for three days, and causes no serious illness among children and young adults (1).  However, pregnant women who are exposed to the disease face a slew of complications (1).  German measles in pregnant women can result in damage to the fetus and potential birth defects, including mental retardation, deafness, cataracts, liver and spleen damage, as well as heart defects (1).  If a pregnant woman is infected with rubella, there is roughly a 20% chance that the fetus will be affected (1).

Rubella- people still get that?

            Due to a successful vaccination program, rubella incidences have significantly dropped in the past several decades.  Through proper protocol, all infants and unvaccinated adults receive two doses of the MMR (mumps, measles, and rubella) vaccine in order to build an immune defense against possible infection (1).  For a while, strong vaccination efforts were followed, resulting in a significant drop in cases of rubella.  However, in recent years, some parents have decided to not vaccinate their children against rubella.  While some feel that the disease is antiquated and there is no purpose in vaccination, others believe that there are potentially harmful effects associated with infancy vaccination.  As psychologists and neurologists attempt to search for the causes of newly emergent autism spectrum disorders, many fear that there may be some sort of correlation between vaccination and the onset of autism.  Although there is no significant scientific data to support such findings, not everyone blocks out potentially false information.  As a result, some childhood diseases, such as rubella, have made a “comeback” and are of concern to children and pregnant women.

Beijing- a rubella case study

            Recently, Chinese epidemiologists have monitored the outbreaks of rubella in Beijing from 2007-2011.  Unlike in the United States, the rubella vaccine was not widely distributed in Beijing until 1995.  Before this, there were high levels of rubella among the residential population, and commuters into the city (floating population).  After the vaccine became widely available, the reported cases of rubella among both the permanent and floating populations drastically lowered.  Through statistical analysis, epidemiologists found that the overall rate in rubella infection has remained relatively stagnant from 2007-2011, but slightly higher than initially after vaccination began.  They also founds that the ratio between floating population incidences and residential incidences has increased.  In some of the years, such as 2007, the rate for the floater population was more than three times greater than that of the residential population. 

            Most importantly, the epidemiologists found that the most infected age group has risen over the last several years.  Before 2005, more than half of all reported rubella cases (floater and residential populations) were found in children younger than nine.  Recently, the age group most affected by rubella shifted to 20-24.   While it may certainly be easier to control sanitation and quarantine efforts in an older population of patients, there are other problems with this shift.  There are more pregnant women in the 20-24 age category, and people in this age group are likely to have more interaction with those susceptible to serious infection.  Also, although this data is novel, there may be a higher number of birth defects caused by rubella due to the older effected population. 

What next?

            Although the Chinese case study is slightly different from the newly emergent rubella epidemics in the United States, the overall principle is the same.  If one group of a population remains unvaccinated, the overall number of cases will increase, and the demographics may also shift.  Thus, it is completely necessary to vaccinate children to prevent those susceptible from becoming infected, and to stop potential outbreaks before they occur.  There is no known link between autism and the MMR vaccine.  Save a life and vaccinate!

Still not sure whether to vaccinate? Maybe this video will change your mind!

Primary Article
Chen M, Zhu Z, Liu D, Huang G, Huang F, Wu J, Zhang T, Xu W, Pang X. 2013. Rubella epidemic caused by genotype 1E rubella viruses in Beijing, China, in 2007-2011. Virology Journal 10 (122).

Secondary Article
Center for Disease Control and Prevention. 2011. Rubella (German measles, Three-Day measles). http://www.cdc.gov/rubella/
NHS Tayside extends MMR vaccine campaign to under 24s. http://www.bbc.co.uk/news/uk-scotland-tayside-central-19720805

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