Rubella virus

Abstract

Rubella virus typically causes only a mild febrile illness with a rash. In childhood the infection is usually trivial, but in a pregnant woman infected during the first trimester serious sequelae may include miscarriage, fetal death or a range of birth defects known as congenital rubella syndrome (CRS). Beginning in 1969 the introduction of rubella virus vaccines to prevent infection steadily reduced the incidence of CRS and has all but eliminated it in countries where vaccine is in wide use. Of lower priority in the developing world, rubella vaccine was not adopted more widely until the 1990s when CRS was still occurring in infants at an estimated incidence of more than 100,000 annually. The World Health Organization (WHO) issued a position paper on rubella vaccine in 2000 to guide countries toward effective incorporation of vaccine into their schedules for childhood immunization. In 2009 WHO highlighted the need for both routine and supplemental immunization activities in order to reach the target ≥80% coverage in childhood as a key step toward global elimination of CRS. It was also recognized that this ambitious goal needed to be coupled with a focus on immunizing women of childbearing age. More recently, key national and international organizations have embraced a Measles and Rubella Initiative representing an even more coordinated partnership aimed at significant reduction of CRS worldwide and elimination in multiple WHO regions by 2020.