The greatest gaps in Rubella virus persist in Africa, where roughly 6 in 10 countries are yet to make the vaccine routinely available to infants, leaving 3 in 10 children globally without access, says World Health Organisation (WHO).
Rubella, also known as German measles, is a mild infection, causing little more than a mild fever and a rash. However, cases are often under-reported, especially in many developing countries, owing to inadequate attention and weak funding of elimination strategies, despite being an epidemic-prone disease.
“Even in countries that have the vaccine in their schedules, significant gaps in access and uptake can persist – potentially leaving large numbers of people still vulnerable to infections with the rubella virus,” the agency states.
Rubella brings immense health risks if a woman contracts it when she is pregnant, 90 percent of women who get it early in pregnancy will pass it on to their unborn babies.
Rubella infection early in pregnancy can lead to miscarriage, stillbirth or congenital rubella syndrome (CRS) in the baby – a condition that includes severe birth defects and lifelong disability, like vision and hearing impairments and heart defects. Deafness occurs in about two-thirds of all those born with CRS.
According to a study by Pan African Medical Journal 2016, the results of few surveys done in Nigeria among (unimmunized) pregnant and women of child-bearing age to determine the prevalence of rubella showed that between 53 percent and 77 percent of the women had rubella, based on the presence of rubella I Immunoglobulin G antibodies.
The reported further states that prevalence will likely continue to increase as a result of the non-introduction of childhood vaccination against the disease and little or no attention being paid towards improving surveillance for Congenital Rubella Syndrome (CRS) and rubella infections.
“Sadly, the most populous country in Africa – Nigeria, with potentially high case burden of rubella has a dearth of data on the prevalence or incidence of rubella infection and is yet to introduce rubella into routine vaccination schedule for under-one or even under-five population,” the report states.
Globally, it is estimated that around 100,000 children are born with CRS every year.
In order to eliminate rubella, rubella vaccine must be included in national immunization schedules. Often, this vaccine is given in combination with measles and sometimes mumps vaccines, meaning it can be easily and affordably introduced into existing programs.
“There is no room for complacency. Even in countries that have eliminated the disease, the job is not yet done. The only way to ensure protection against rubella is to make sure that all children are vaccinated against it, alongside surveillance systems that are strong enough to quickly detect cases and respond rapidly to stop the spread – especially to pregnant women,” says Shalini Desai, an expert in rubella at WHO and author of the report.
“Stopping rubella for good means not only introducing the vaccine but also building the strong immunization and healthcare systems that will ensure no child misses out on essential vaccinations,” says the head of WHO’s immunization program, Kate O’Brien. “It will take political and community leadership and commitment to ensure elimination targets are set, achieved, and sustained, so that rubella can become a disease of the past, in every part of the world.”
