An infection once feared by pregnant women has been all but wiped out in Australia thanks to a vaccine that has been a fixture of childhood vaccinations for almost three decades.
The World Health Organisation on Wednesday declared that rubella, also known as German measles, had been eliminated in Australia, according to its official threshold.
Nationally there have been just eight reported cases so far this year (including two in Victoria and one in NSW) and they were most likely as a result of people bringing in the illness from overseas.
“The science is in and the medical experts’ advice is absolute - vaccinations save lives and protect lives,” said Federal Health Minister Greg Hunt.
The trickle of cases today are a far cry from the epidemics of the late 1950s and early 1990s, which saw thousands of people infected, and resulted in stillbirths and birth defects that had life-long impacts.
Rubella often causes a rash and mild symptoms such as nausea, a low fever and conjunctivitis.
For some, the illness is so innocuous people do not realise they have it, but the infection remains extremely dangerous for pregnant women, especially in the first trimester.
In about 85 per cent of cases it causes miscarriage, stillbirth or other serious side-effects to the developing foetus that results in the baby being born deaf, developmentally delayed or struggling with heart defects.
“There are still people living with deafness that contracted it from rubella,” said Australia’s chief medical officer Professor Brendan Murphy.
“The deafness is permanent and it’s by far the commonest abnormalities.”
Professor Elizabeth Elliott from the University of Sydney said when she first started working in paediatrics almost four decades ago she would see children born deaf and with eye and heart problems as a result of rubella exposure during early pregnancy.
“The other really concerning thing is some of these children had microcephaly or small brain, hence were developmentally delayed… really confining that child to a life where they had significant disability,” she said.
“They were children whose mother might have had a rash or fever during pregnancy, which was often quite trivial.”
Professor Elliott said the Australian Paediatric Surveillance Unit had been monitoring congenital rubella infections since 1993 and identified 60 cases in that time, but none in recent years.
She said it was great news that Australia had all but eliminated rubella, but it was also important that immigrants were still screened to ensure they had received vaccinations and pregnant women who had come from at-risk countries were also monitored.
The rubella vaccine was first rolled out in Australia in 1971 for schoolgirls. It was added to the childhood vaccination program in 1989, and is now given with an injection combined with measles and mumps at one year and then 18 months.
Professor Murphy said while there were still the occasional cases of rubella identified in Australia, including 10 in 2017, the infections were mostly not caught locally.
“If you come into an antivaxer community there is always a risk you could have a bit of local spread… but we don’t have any sustained transmission in our community.”
Mr Hunt said as measles and rubella remained endemic in many countries, it was vital Australians remained vigilant and kept their vaccines up to date. Last week he announced that national childhood vaccination rates had risen to record levels, at 94.62 per cent.