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| RUBELLA |
Disease
Rubella occurs worldwide and is normally a mild childhood disease. However, infection during early pregnancy may cause fetal death or congenital rubella syndrome which is characterized by multiple defects, particularly of the brain, heart, eyes and ears. CRS is an important cause of hearing and visual impairment and mental retardation in countries where acquired rubella infection has not been controlled or eliminated.
Occurrence
Although the worldwide burden of congenital rubella syndrome is not well characterized, it is estimated that more than 100 000 cases occur each year in developing countries alone.
Risk for travellers
Travellers who are not immunized against rubella may be at risk when visiting countries where the vaccine coverage is suboptimal. Particular attention should be paid to ensuring protection of women who may become pregnant during the period of travel.
Vaccine
The internationally licensed rubella vaccines, based on live attenuated RA 27/3 strain of the rubella virus and propagated in human diploid cells, have proved to be safe and efficacious. Following well designed and implemented programmes using such vaccines, rubella and congenital rubella syndrome have almost disappeared from many countries. Other attenuated vaccine strains are available in Japan and China.
Rubella vaccine is commercially available in a monovalent form, in a bivalent combination with either measles or mumps vaccine, and in the trivalent Measles/Mumps/Rubella (MMR) vaccine. Rubella vaccine should be used to protect against rubella in seronegative child bearing age. Vaccination should never be given during pregnancy and pregnancy has to be avoided within one month of vaccination. Vaccine should be especially offered to previously unimmunised and seronegative post partum women. Vaccination within few days after 1st delivery is important because about 60% of congenital abnormalities from rubella infection occur in babies of women who have borne more than one child. |
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