>From the newsroom of the News 14 Carolina (Cable TV), Raleigh, North
Carolina, Wednesday, March 17, 2004 .....

Rubella's Lasting Impact

By: Medstar.com

Like polio and smallpox, rubella or German measles has virtually been
eliminated in the U.S. When the last epidemic swept the country 40 years
ago, many pregnant women experienced such mild symptoms they didn't even
know they had rubella, but an estimated 20,000 of their babies were born
with a host of serious health problems. Now an unknown number of those
"rubella babies," may get even sicker as adults.

Stephen Wenzler, 39, was a "rubella baby." Born with congenital rubella
syndrome or CRS, he grew up deaf with limited vision and a heart defect.
Now, as an adult, he has more health problems.

"My vision became fuzzy and I already had a corneal transplant but it didn't
appear to be working well," Stephen said, through an interpreter. "Very
recently, my family doctor discovered I have Type Two Diabetes."

At the Helen Keller National Center for Deaf-Blind Youth and Adults in New
York, Nancy O'Donnell heard many tales of adult rubella children developing
serious late onset medical conditions. So she surveyed the center's more
than 900-case database.

"We found high instances of diabetes in the group, glaucoma, and we also
found esophageal problems, gagging, vomiting, problems with eating, some
thyroid disorders, hormonal problems and in very rare cases a degenerative
process in the whole body," O'Donnell said.

Everyone wondered - could these adult problems be linked to rubella?

"If we could get that documentation then it would really improve the kinds
of services and care, in terms of long term care as well," O'Donnell
continued.

O'Donnell is spearheading a project with the CDC to find out if biological
markers of the rubella virus persist in the body into adulthood. Such
markers could be used to definitively diagnose the condition.

Despite his medical uncertainties, Stephen is getting ready for a career in
computers.

According to Stephen, "I'm planning to go out into the world of work and I
wanna fully function out there."
Knowing what to expect with his health could be a big help in planning his
future.

During this year's 40th anniversary of the last U.S. rubella outbreak, the
Helen Keller National Center hopes to raise awareness of CRS and spur the
medical community to do more research.

- - - - - - - - - -

For more information

For information about the study, visit the Helen Keller National Center
website (
http://www.hknc.org/Rubella.htm).

Rubella Dangers

Rubella is an infection caused by a type of togavirus, called the Rubivirus.
It is also known as German measles or 3-day measles. The virus is spread by
contact with contaminated respiratory droplets or close contact with an
infected person. Signs of infection include: red rash, mild fever, headache,
swollen lymph nodes, sore throat, red or tearing eyes, runny nose and joint
pain.

In many cases, symptoms of rubella are often very mild and up to 40 percent
of patients never know they have acquired the virus. Those that develop
signs of infection usually respond well to supportive care (rest,
medications to reduce fever).

Rubella becomes dangerous when the virus is acquired by a woman in the early
course (first trimester) of pregnancy. The virus interferes with cell
division, causing incomplete, delayed or defective development of organs and
body parts. In addition, the rubella virus inappropriately stimulates the
fetal immune system, leading to inflammation and cellular damage. The
infection can lead to fetal death, premature birth, or a variety of medical
problems, known as congenital rubella syndrome, or CRS.

Researchers estimate 25 to 30 percent of infants born to rubella-infected
mothers develop CRS. Children tend to be small in size and may experience
hearing loss, heart problems, cataracts, glaucoma, developmental delay
and/or mental retardation.

Congenital Rubella Syndrome - Late Effects

Between 1964 and 1965, a rubella epidemic broke out in the U.S. Roughly 12.5
million cases of rubella were reported and about 200,000 babies were born
with congenital rubella syndrome. A little more than twenty years after the
epidemic, parents began reporting a sudden onset of new, unusual symptoms in
CRS children. Some of the late effects include: diabetes, glaucoma, retinal
detachment, hormone and thyroid problems, swallowing/digestive problems,
deterioration in cognitive performance, seizures and behavioral problems.
Doctors don't understand the cause of the new symptoms.

2004 is the 40th anniversary of the 1964/1965 U.S. rubella outbreak. To mark
the important date, researchers are gathering as much data as possible about
the late symptoms that appear to be associated with CRS. Hopefully, the data
will provide some clues about how or why patients are developing the new
signs (i.e., are they the result of CRS, medication use or inherited
tendencies?). The CDC will be collecting blood samples from survey
volunteers to look for biomarkers of CRS. The test may eventually be useful
to determine if CRS is the cause of the symptoms in patients who may been
exposed to the rubella virus, but didn't develop any notable signs of
infection.

Rubella vaccination began in the U.S. in 1969 and the number of cases of CRS
have dramatically declined. However, from time to time, incidences are still
reported. Between 1990 and 1999, 117 cases of CRS were reported. Only one of
the mothers had reported receiving a rubella vaccination. Health experts say
universal rubella vaccination is the only way to prevent maternal infection
with the virus and reduce the risk of congenital rubella syndrome.

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