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Rubella Virus Eliminated in the United States

The classical "triad" of rubella birth defects is cataracts, deafness and malformations of the heart, but the list of possible defects is much longer. They include bone abnormalities, liver enlargement, mental retardation and delayed development. Of 430 New York children with the syndrome studied in the 1960s, 6 percent had autism. That discovery was the first evidence that autism -- at the time thought to arise from bad parenting -- was shown to have biological origins in fetal development, at least in some cases.

Rubella is less contagious than measles but still easily transmitted by coughing and close contact. Before the vaccine, epidemics occurred in the United States in cycles of six to nine years. Because infection confers natural immunity, that was the length of time it took for enough susceptible people to accumulate in the population to permit sustained person-to-person transmission.

_____Graphic_____
Rubella Extinguished
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In 1964 and 1965, rubella exploded. There were 12.5 million infections here, which gave rise to 20,000 cases of the congenital syndrome, about 6,200 stillbirths, and at least 5,000 abortions -- some legal and some not. The epidemic also gave a great push to Stanley Plotkin, a research physician at the Wistar Institute in Philadelphia, who had begun working on a rubella vaccine in 1963.

Plotkin subjected a strain of rubella virus to repeated rounds of growth in harsh conditions in tissue culture. This caused genetic changes that rendered the microbe too weak to cause illness yet still capable of stimulating immunity.

His final product proved unusually effective and safe. A single dose confers life-long immunity in nearly all people. Among the thousands of women who turned out to be pregnant when they got the vaccine over the years, none has ever had a baby with congenital rubella.

Now 72 and an adviser to the pharmaceutical firm Sanofi Pasteur, Plotkin recalled last week that opponents of abortion briefly questioned whether it was ethical to use the vaccine, because it was developed with virus isolated from an infected fetus that had been legally aborted in Pennsylvania in 1965. Roman Catholic authorities, however, pronounced it acceptable.

"I have no doubt that rubella vaccination has prevented thousands and thousands of abortions," he said. "From strictly an arithmetical assessment, the good done by the vaccine -- if you are opposed to abortion -- is infinitely greater than any possible harm."

The secondary effects of the 1964-65 outbreaks were considerable. They included a loosening of abortion laws in several states and the passage of the first federal program to help pay for services for multiply handicapped children, starting at birth.

"The good news was that following that epidemic, we had the ammunition that helped spur the commitment to children with special needs," recalled pediatrician Louis Z. Cooper, whose New York City research group helped more than 1,000 children disabled by congenital rubella.

When those babies grew up, some sought admission to Gallaudet, which in 1980 had about 1,200 students, said David Armstrong, the university's budget director. What is known on campus as the "rubella bulge" brought in so many new students that Gallaudet acquired a satellite campus -- the former home of Marjorie Webster Junior College -- in Northwest Washington.

Enrollment peaked at 1,900 in 1988. By the mid-1990s, Gallaudet's student body was back down to 1,200. The Northwest campus was sold, a harbinger of rubella's final descent.


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