30th April 2015

Rubella has been eradicated from the Americas

The World Health Organisation (WHO) has officially declared that rubella – also known as the German measles – has been eradicated from the Western Hemisphere.

The Americas region has become the first in the world to be declared free of endemic transmission of rubella, a contagious viral disease that can cause multiple birth defects, as well as foetal death when contracted by women during pregnancy. This achievement culminates a 15-year effort that involved widespread administration of the measles, mumps and rubella (MMR) vaccine throughout the Western Hemisphere.

The declaration, made by an international expert committee during a meeting at the Pan American Health Organisation/World Health Organisation (PAHO/WHO), makes rubella the third disease to be eliminated from the Americas – following the regional eradication of smallpox in 1971 and the elimination of polio in 1994. Congenital rubella syndrome (CRS) becomes the fourth.

"The elimination of rubella from the Americas is a historic achievement that reflects the collective will of our region's countries to work together to achieve ambitious public health milestones," said PAHO/WHO Director, Carissa Etienne. "Ours was the first region to eradicate smallpox, first to eliminate polio, and now the first to eliminate rubella. All four achievements prove the value of immunisation and how important it is to make vaccines available even to the remotest corners of our hemisphere."

"Three years ago, governments agreed a Global Vaccine Action Plan. One of the plan's targets is to eliminate rubella from two WHO regions by end-2015. I congratulate the Americas Region for being the first region to achieve this," said Dr Margaret Chan, director general of the World Health Organisation.

Rubella, also known as German measles, caused widespread outbreaks throughout the Americas before the introduction of the MMR vaccine. Although the virus usually causes mild or asymptomatic infections in children and adults, when contracted by women early in pregnancy it can trigger miscarriage or CRS, an array of birth defects that includes blindness, deafness, and congenital heart defects. Before mass-scale rubella vaccination up to 20,000 or more children were born with CRS each year in Latin America and the Caribbean, while over 158,000 rubella cases were reported in 1997 alone. In the United States, 20,000 infants were born with CRS during the last major rubella outbreak (1964-65).

The last endemic (local origin) cases of rubella and CRS were reported in the Americas during 2009. Because the virus continues to circulate in other parts of the world, imported cases from outside the Americas have continued to be reported. Experts reviewed evidence provided by PAHO/WHO and concluded there was no endemic transmission of rubella or CRS for five consecutive years – exceeding the three-year requirement for declaring the disease eliminated. Other regions hoping to follow next include Eastern Europe, Russia and Central Asia.

"The fight against rubella has taken more than 15 years, but it has paid off with what I believe will be one of the most important Pan-American public health achievements of the 21st century," said Etienne. "Now it's time to roll up our sleeves and finish the job of eliminating measles as well."

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