Cox, Frank

Quinn, E. L.

Romig, Donald

English

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Henry Ford Hospital Medical JournalVolume 18 | Number 1 Article 113-1970Rubella: Current Status of ImmunizationE. L. QuinnFrank CoxDonald RomigFollow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournalPart of the Life Sciences Commons, Medical Specialties Commons, and the Public HealthCommonsThis Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in HenryFord Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons.Recommended CitationQuinn, E. L.; Cox, Frank; and Romig, Donald (1970) "Rubella: Current Status of Immunization," Henry Ford Hospital Medical Journal: Vol. 18 : No. 1 , 73-74.Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol18/iss1/11Henry Ford Hosp. Med. Journal Vol. 18, No. 1, 1970 NOTES AND COMMENTS Rubella: Current Status of Immunization E. L . Quinn, M.D., Frank Cox, M.D. and Donald Romig, M.D.* The chief cause of concern with rubella—German measles—is its effect on the fetus when the virus infects a pregnant woman. An estimated 247,-000 women in their first trimester of pregnancy contracted rubella in the 1963-64 epidemic.^  The results: 8,000 to 30,000 fetal deaths and approxi-mately 20,000 children born with con-genital anomalies which included deaf-ness, eye defects, mental retardation and heart lesions. Since epidemics of rubella occur at 6 to 7-year intervals, usually in spring, U.S. authorities are concerned about the repetition of this problem in 1970-1971. Fortunately, the recent develop-ment and availability of an effective rubella vaccine may avert this tragedy if immunization is properly and widely used. The vaccine is the direct descendant of viruses first isolated by Parkman, and independently by Weller and their co-workers in 1961. In the United States, it is expected that the vaccine will control rubella through the estab-lishment of "herd immunity" among children, the group in which the disease is most common. It is the children who usually transmit the teratogenic virus to •Division of Infectious Diseases the 15%to 20% of pregnant women who are susceptible. Because mass vaccination programs have largely eliminated polio and sharply curtailed measles (rubeola) by the establishment of herd immunity, it is felt the same can be accomplished with the rubella vaccine. To this end, the live, attenu-ated rubella virus vaccine should be given to all children—boys as well as girls—between the ages of one year and extending through the elementary school population. In addition, the physician will be requested to give the vaccine to many adult women. The susceptibility to ru-bella in these patients may be demon-strated by absence of specific serum hemagglutinating antibody. Since the vaccine virus can infect the fetus, im-munization should be used only if preg-nancy can be excluded in sexually-active women of child-bearing age and wiU be avoided for at least three months after vaccination. This requires a nega-tive pregnancy test, administration of vaccine during a menstrual period or immediately after childbirth. Preven-tion of conception must be assurred by abstinence or use of effective contra-ceptives during the ensuing few months. In children, reactions to vaccine are rare, ie, occasional mild fever, local soreness at the site of injection and 73 Quinn, Cox and Romig arthralgia. Rash was reported in only a few instances. Spread of the vaccine virus to others has not been a problem. Arthralgia and transient arthritis oc-cur more frequently in women than in children. Further attenuation of the virus in the vaccine may reduce ad-verse reactions but may also reduce the vaccine's protective values. When they were adequately prewarned, pa-tients to whom we gave the vaccine willingly accepted the possibility and occurrence of adverse reactions. The use of the live rubeUa virus vaccine should be avoided in patients with altered immune states or hyper-sensitivity to vaccine components (in-dicated on the label). Also, present recommendations are that administra-tion should be separated by at least one month from the administration of other live virus vaccines. REFERENCES 1. Krugman, S.: Oral presentation, International Conference on Rubella Immunization, 1969. 2. Parkman, P. D.; Buescher, E. L., and Artenstein, M. S.: Recovery of rubella virus from Army recruits. Proc Soc Exp Biol Med 111:225, 1962. 3. Weller, T. H., and Neva, F. A.: Propagation in tissue culture of cytopathogenic agents from patients with rubella-like illness. Proc Soc Exp Biol Med 111:215, 1962. 74 

Rubella: Current Status of Immunization

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Rubella: Current Status of Immunization

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