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Birth Defects from Rubella Rising, as Mothers Slip Past Immunization

May 19, 1992

CHICAGO (AP) _ Birth defects from rubella, which all but disappeared during the 1980s, are afflicting more and more babies of women who slipped past the usual screenings for immunization, researchers say.

Just two cases of defects from congenital rubella syndrome were recorded in the United States in 1989, the researchers reported in Wednesday’s Journal of the American Medical Association.

Last year, there were 24 cases. In addition, the incidence of rubella had increased fivefold since 1988, to 1,372 cases, the federal Centers for Disease Control said.

In a study of 21 infants with congenital rubella syndrome after a rubella outbreak in California in 1990-91, the CDC found that over half could have been healthy if opportunities for immunizing the mothers had not been missed.

″These cases are a small percentage of what truly is out there,″ said Dr. Susan H. Lee, who headed the study. All cases are preventable with a vaccine costing $15 to $25, she said from Atlanta.

The study’s authors recommended that women be screened after giving birth and those who hadn’t been immunized as children receive the vaccine to prevent birth defects in future children.

″Postpartum immunization alone can prevent 33 percent to 50 percent of all congenital rubella syndrome cases,″ the researchers said.

Caring for an infant with congenital rubella syndrome costs $354,000 over a lifetime, said Kay Johnson of the March of Dimes Birth Defects Foundation, citing government figures.

″These kids are profoundly mentally retarded,″ she said from White Plains, N.Y. ″Most need a lifetime of institutionalization or other rehabilitative care.″

The 31,000-member American College of Obstetricians and Gynecologists favors vaccinating unprotected women after childbirth, said spokeswoman Kate Ruddon. Women should not conceive for three months after vaccination because the vaccine could theoretically cause birth defects, she said.

Authors of the study found that 12 of the 21 women who delivered infants with congenital rubella syndrome had a total of 22 known missed opportunities for screenings or vaccinations.

The missed opportunities occurred during premarital tests and previous pregnancies, childbirths or abortions. The typical woman who had missed opportunities was age 20 to 24 and a foreign-born Hispanic or white woman using illicit substances, the researchers said.

Rubella, sometimes called three-day measles, is a mild, infectious disease caused by a virus. It is different from regular measles, or rubeola, though both cause skin rashes.

Rubella’s chief danger is to fetuses of infected women, especially during the first trimester, when it can cause severe defects.

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