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Our Global Voices Posts

Rubella and CRS Elimination: A Race Worth Winning

Posted on by Susan Reef, MD, MPH, Medical Epidemiologist and Rubella Team Lead, Global Immunization Division & Gavin Grant, MD, MPH, Medical Epidemiologist, Global Immunization Division

AEFI management kit
AEFI Management Kit. Photo credit: Rania Tohme/CDC

More than 100,000 children worldwide are born with congenital rubella syndrome (CRS) every year to mothers infected with the rubella virus. Sadly, these children will suffer a lifetime because of birth defects such as blindness, deafness, and heart disease, even though a cost-effective vaccine is widely available to prevent both rubella and CRS. This is why rubella and CRS elimination is a race worth winning.

Many people underestimate the value of vaccines when it comes to protecting unborn children, especially if the vaccine-preventable disease does not have devastating effects in children and adults. This is the case with rubella. Rubella usually causes a mild fever and rash in children and adults. Though uncommon, it can also cause encephalitis and arthritis in women. However, rubella infection during pregnancy, especially during the first trimester, can result in miscarriage, stillbirth, or infants with congenital malformations, known as CRS. Up to 90% of neonates born to mothers infected in the early weeks of pregnancy will have CRS.

A report this week shows that 125 countries around the world still report CRS cases. Various countries are diligently using vaccines to fight and eliminate both rubella and CRS. As of 2016, 152 of 194 countries introduced rubella-containing vaccines into their national immunization schedule – an increase of 53 countries since 2000. As a result, overall rubella cases declined 97% from 670,894 in 2000 to 22,361 in 2016. In the Americas, the last endemic rubella and CRS cases were reported in 2009, and the region was verified free of endemic rubella virus transmission in 2015. In the World Health Organization (WHO) European Region, 33 countries had eliminated rubella by 2016. Despite these achievements, there is still more work ahead.

Rubella and CRS surveillance play a critical role in assessing and monitoring disease burden and epidemiology before and after vaccine introduction, and progress towards elimination. Surveillance also helps identify pregnant women infected with rubella virus who will require follow up to assess pregnancy outcomes as well as to identify, diagnose, and manage CRS-affected infants medically. We also must work diligently to overcome challenges in achieving rubella elimination goals, including natural disasters or civil unrest affecting vaccine delivery, transmission in older populations, vaccine hesitancy, and weak healthcare service delivery with low routine vaccination coverage.

It is widely recognized that vaccines can protect people from certain debilitating and deadly diseases. This is why agencies like the WHO provide guidance to countries on their national immunization schedules. Nevertheless, vaccine-preventable diseases still pose public health challenges. The Global Vaccine Action Plan 2011-2020 includes goals to eliminate rubella and CRS throughout most of the world by 2020. The increase in countries introducing rubella-containing vaccines into their national immunization schedule and the achievement of rubella elimination in the Region of the Americas proves that we are making progress. Now it is time to cross the finish line to win the race in eliminating CRS around the world.

 

Posted on by Susan Reef, MD, MPH, Medical Epidemiologist and Rubella Team Lead, Global Immunization Division & Gavin Grant, MD, MPH, Medical Epidemiologist, Global Immunization DivisionLeave a commentTags , , ,

Everyone Needs Somewhere to Go: World Toilet Day

Charcoal briquettes manufactured from human waste in East Africa

Charcoal briquettes manufactured from human waste in East Africa (Photo courtesy of Eric Mintz, CDC) We use toilets every day – at home, school, and work – yet 40% of the world’s population does not have this luxury.  Clean and safe toilets are more than just a place to use the restroom.  They are essential Read More >

Posted on by By Madison Walter, MPH, CHESLeave a commentTags ,

Overcoming obstacles to polio eradication in Pakistan

Picture of worker distributing polio advocacy items to children.

Originally published on October 5, 2017 on Rotary Voices “Coming together is a beginning. Keeping together is progress. Working together is success.” Henry Ford When I first joined Pakistan’s PolioPlus Committee (PNPPC) as a manager close to eight years ago, polio eradication seemed within our reach. I used the opportunity to study poliomyelitis beyond just Read More >

Posted on by Alina A. Visram, manager, Pakistan National PolioPlus CommitteeLeave a commentTags ,

Precision Public Health: Using Malawi Population-Based Impact Assessment (MPHIA) Data to Reach HIV Epidemic Control in Malawi

The Malawi Population-Based HIV Impact Assessment (MPHIA) is Malawi’s first nationally representative HIV survey that measures national HIV incidence, pediatric HIV prevalence, and viral load suppression. MPHIA has provided detailed information on the current status of the HIV epidemic and the uptake of HIV prevention, care, and treatment services in Malawi. In his remarks during Read More >

Posted on by Nellie Wadonda-Kabondo and Danielle PayneLeave a commentTags , , , ,

Looking Ahead to a Measles and Rubella Free World

Robert Linkins, MPH, PhD

Vaccines fight diseases and save lives. Think of achievements like smallpox eradication, a polio-free world close at hand, and 2-3 million deaths prevented each year through routine immunizations. Yet despite a safe and effective vaccine against measles and rubella, these deadly viruses continue to steal the health and lives of children all over the world. Read More >

Posted on by Robert Linkins, MPH, PhDLeave a comment

Optimistic in the Face of Ongoing Tragedy: Progress toward a World Free of Human Rabies

During her presentation at 2017 PARACON meeting on how to plan and budget for a mass dog vaccination campaign, Emily Pieracci asked who was committed to ending rabies.

Rabies is a fatal disease that kills an estimated 59,000 people each year, almost half of whom are children. The majority of deaths occur in Africa and Asia. All of these deaths are vaccine-preventable with timely administration of post-exposure prophylaxis (PEP), the shots needed to prevent rabies from developing in bite victims. So why is Read More >

Posted on by Emily PieracciLeave a comment

CDC Global Rapid Response Team Pilots Workshop for Senegal and Burkina Faso

Global Rapid Response Team

Participants to the Rapid Response Team Management workshop, Dakar, Senegal, August 7-11 The 2014-2016 Ebola epidemic clearly demonstrated the need for trained scientists who can deploy quickly to confront health threats and ensure global health security. While we often think about the emergency response itself, we typically don’t think about the work that happens behind Read More >

Posted on by Global Rapid Response TeamLeave a comment

Making some noise about noncommunicable diseases in Rwanda

We weren’t sure what to expect when the Rwanda Biomedical Center requested a training for their noncommunicable disease (NCD) program managers. We had never delivered this particular curriculum before, but after three months of preparation, our journey from Atlanta began. After landing in the capital Kigali, we faced a bumpy three-hour drive into the mountains Read More >

Posted on by Kristy Joseph, MA, CDC Global NCD BranchLeave a comment

Parasitologist for the People

LT Knipes chats with school children who have been enrolled and are waiting to be tested for lymphatic filariasis and malaria in Nord Est Department, Haiti.

Global health emergencies are a constant in today’s world. In recent years, we have seen the impact of natural disasters, mass migrations, famines, conflicts, and more. When there are large population movements, we see rapid spread of infectious disease. When there is famine, those affected have a compromised immune system, allowing them to contract illnesses easier. For these reasons it is vital that public health staff from the Centers for Disease Control and Prevention (CDC) is on the scene. Read More >

Posted on by Adrienne Lefevre, MPH, CHESLeave a commentTags , , , ,

Are Ebola response investments making an impact? CDC Epidemiologist reflects on West Africa then and now

The first time I deployed to West Africa was in September 2014, at the height of the Ebola epidemic in Sierra Leone. I have witnessed many disease outbreaks in my public health career, but this one was more devastating than I could ever have imagined. It eventually took more than 11,000 lives. What was happening Read More >

Posted on by John T, Redd, MD, MPH, FACP, CAPT, US Public Health Services, CDCLeave a commentTags , , , ,
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