Rubella in the developing world

Abstract

Before Gregg's historic observation [1] rubella was not considered to have clinical or epidemiological importance in any country. In the western world epidemics occurred at varying intervals but with little morbidity and apparently only minor complications. Despite confirmation of Gregg's findings from many quarters, it was not until the worldwide outbreaks in the 1960s that the aftermath of rubella infection in pregnancy was fully realized. As a result of the 1964 outbreak in New York City, more than 1000 children were born with congenital rubella syndrome (CRS) and over 300 pregnancies either aborted spontaneously or were terminated for rubella infection [2]. The number of children affected represented 1% of births in the city; if extrapolated to the whole country this gave an estimated total of 30000 cases of CRS. No such disasters have so far been reported from the developing world.