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| '''Incidence''' | | '''Incidence''' |
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| Rubella is a disease that occurs worldwide. Rubella infection often peaks during the spring in countries with temperate climates. Before the vaccine to rubella was introduced in 1969, widespread outbreaks usually occurred every 6-9 years in the United States and 3-5 years in Europe, mostly affecting children in the 5-9 year old age group.<ref name="pmid11798368">{{cite journal
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| |author=Reef SE, Frey TK, Theall K, ''et al''
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| |title=The changing epidemiology of rubella in the 1990s: on the verge of elimination and new challenges for control and prevention
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| |journal=JAMA
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| |volume=287
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| |issue=4
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| |pages=464–72
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| |year=2002
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| |pmid=11798368
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| |doi=
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| |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=11798368
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| }}</ref> Since the introduction of vaccine, occurrences have become rare in those countries with high uptake rates. However, in the UK there remains a large population of men susceptible to rubella who have not been vaccinated. Outbreaks of rubella occurred amongst many young men in the UK in 1993 and in 1996 the infection was transmitted to pregnant women, many of whom were immigrants and were susceptible. Outbreaks still arise, usually in developing countries where the vaccine is not as accessible.<ref name="pmid16989272">{{cite journal
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| |author=Reef S
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| |title=Rubella mass campaigns
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| |journal=Curr. Top. Microbiol. Immunol.
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| |volume=304
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| |issue=
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| |pages=221–9
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| |year=2006
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| |pmid=16989272
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| |doi=
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| }}</ref> There has been a decrease in the number of reported rubella cases globally from 875,000 in 1999 to about 101,331 in 2013, however, this incidence is believed to be underestimated as some rubella cases are missed in many countries.<ref name="Goldman-Cecil Medicine">Goldman, Lee; Schafer, Andrew (2016). "Chapter 368:Rubella (German Measles)". Goldman-Cecil Medicine, 25th Edition. Elsevier. pp. 2204–2206. ISBN 9781455750177.</ref> During the epidemic in the US between 1962-1965, Rubella virus infections during pregnancy were estimated to have caused 30,000 still births and 20,000 children to be born impaired or disabled as a result of CRS.<ref name="pmid11348695">{{cite journal
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| |author=Plotkin SA
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| |title=Rubella eradication
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| |journal=[[Vaccine]]
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| |volume=19
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| |issue=25-26
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| |pages=3311–9
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| |year=2001
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| |pmid=11348695
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| |doi=
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| |url=http://linkinghub.elsevier.com/retrieve/pii/S0264410X01000731
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| }}</ref><ref>Cooper,L.Z. Congenital Rubella in the United States. 1975 In: Krugman,S Gershon,A (eds), Symposium on Infections Of the Fetus and Newborn Infant. New York, Alan R. Liss Inc.,p.1.</ref>
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| Universal immunization producing a high level of [[herd immunity]] is important in the control of epidemics of rubella.<ref name="pmid11105178">{{cite journal
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| |author=Danovaro-Holliday MC, LeBaron CW, Allensworth C, ''et al''
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| |title=A large rubella outbreak with spread from the workplace to the community
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| |journal=JAMA
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| |volume=284
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| |issue=21
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| |pages=2733–9
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| |year=2000
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| |pmid=11105178
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| |doi=
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| |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=11105178
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| }}</ref> Rubella and congenital rubella syndrome became nationally notifiable diseases in 1966. The largest annual total of cases of rubella in the United States was in 1969, when 57,686 cases were reported (58 cases per 100,000 population). Following vaccine licensure in 1969, rubella incidence declined rapidly. By 1983, fewer than 1,000 cases per year were reported (less than 0.5 cases per 100,000 population). A moderate resurgence of rubella occurred in 1990–1991, primarily due to outbreaks in California (1990) and among the Amish in Pennsylvania (1991). In 2003, a record low annual total of seven cases was reported. In October 2004, CDC convened an independent expert panel to review available rubella and CRS data. After a careful review, the panel unanimously agreed that rubella was no longer endemic in the United States.
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| '''Age'''
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| Until recently, there was no predominant age group for rubella cases. From 1982 through 1992, approximately 30% of cases occurred in each of three age groups: younger than 5, 5–14, and 15–39 years. Adults 40 years of age and older typically accounted for less than 10% of cases. However, since 1993, persons 15–39 years of age have accounted for more than half the cases. In 2003, this age group accounted for 71% of all reported cases. Most reported rubella in the United States since the mid-1990s has occurred among Hispanic young adults who were born in areas where rubella vaccine is routinely not given.
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| ==References== | | ==References== |