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SASTM Newsflash - Rubella: Japan - Incresing incidence

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RUBELLA - JAPAN: INCREASING INCIDENCE

 

A Rubella pandemic has continued in Japan. Especially in Tokyo, the number of reported rubella cases in a week has exceeded 100 cases over several weeks. According to the National Institute of Infectious Diseases, as of week 10, 2013 (as of 13 Mar 2013), 1656 rubella patients have been reported. This number is still rapidly increasing and reaching to 2353 which is the number of rubella cases reported by prefecture and methods of diagnosis in week 52, 2012 (as of 8 Jan 2013).

 

In February 2013, a 25-year-old man who had generalized seizure with fever and rash was diagnosed with rubella encephalitis by the detection of rubella virus from throat swab and seroconversion of IgM antibodies at the National Center for Global Health and Medicine hospital in Tokyo. Rubella is known to potentially cause serious complications such as encephalitis. This is the second reported case of encephalitis due to rubella in Japan since last summer.

 

Moreover, in the 10th week of 2013, a second case of congenital rubella syndrome (CRS) was reported from Aichi prefecture which is located around the middle of Japan. In total 7 cases of CRS has been reported since the beginning of this epidemic of rubella last year [2012].

 

Generally, rubella is [more common] in the spring to summer. So the number of patients in the future likely will continue to increase. The Tokyo Prefectural Government on 14 Mar 2013 decided to pay a part of the cost of rubella vaccination in adults aged over 19 years old as emergent preventive measures against this epidemic. Urgent vaccinations against rubella needs to be promoted for all of people who have never had rubella before and have not been immunized against it.

 

As a result of the circumstance that in Japan prior to 1995 male children were not administered rubella vaccine. As a consequence of this there is currently a marked increase in rubella virus infection among males aged predominantly between 20 and 40 years of age. Since the beginning of 2013 a total of 2353 rubella cases have been reported. This number is still rapidly increasing and reaching to 2353. As a consequence an urgent vaccination campaign against rubella has been implemented to protect all people who have never had rubella before and have not been immunized against it.

 

Rubella is an acute, contagious viral infection. While the illness is generally mild in children, it has serious consequences in pregnant women, causing fetal death or congenital defects known as congenital rubella syndrome (CRS). When an adult woman is infected with rubella virus early in pregnancy, she has a 90 percent chance of passing the virus on to her fetus. This can cause miscarriage, stillbirth, or severe birth defects known as CRS. Infants with CRS may excrete the virus for a year or more. Children with CRS can suffer hearing impairments, eye and heart defects, and other lifelong disabilities, including autism, diabetes mellitus, and thyroid dysfunction, many of which require costly therapy, surgeries, and other expensive care.

 

Rubella vaccine is normally included as a component of the MMR (measles, mumps, rubella) triple vaccine administered in early childhood. The rubella component of the MMR triple childhood vaccine is a live [naturally] attenuated strain that has been in use for more than 40 years. A single dose gives more than 95 percent long-lasting immunity, which is similar to that induced by natural infection. The reason for the past policy in Japan to withhold rubella vaccine from male children prior to 1995 is unclear.

 

Communicated by: ProMed mail

 

 


 

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