Date: Sat 14 Sep 2019
Source: Vax Before Travel [edited]
A new report from Japan's National Institute of Infectious Disease (NIID) indicates the Rubella virus outbreak continues to spread. As of [4 Sep 2019], there have been 2156 Rubella cases reported by the NIID during 2019.
This is an increase of about 260 rubella cases in Japan since July 2019. On a local basis, the city of Tokyo has reported 37% of Japan's 2019 Rubella cases.
Since Rubella is very dangerous for a pregnant woman and her developing baby, the US Centers for Disease Control and Prevention (CDC) said on [7 Aug 2019], "pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak."
But, pregnant women should not get a Rubella vaccination with the measles-mumps-rubella (MMR) says the CDC. This is because the MMR vaccine is an attenuated "live virus" vaccine.
The CDC says "pregnant women who are not vaccinated should wait to get [the] MMR vaccine until after they have given birth. And, women of childbearing age should avoid getting pregnant for at least 4 weeks after receiving the MMR vaccine."
Additionally, the CDC says "if a pregnant woman contracts the rubella virus, her baby could have birth defects such as deafness, cataracts, heart defects, mental disabilities, and organ damage."
And, when a rubella infection occurs during early pregnancy, serious consequences, such as miscarriages, stillbirths, and severe birth defects in infants, which are known as Congenital Rubella Syndrome (CRS), [may result].
This new NIID report indicates there have been 3 CRS cases in Japan during 2019. As a comparison, during 2005-2015 in the USA, only 8 babies with CRS were reported.
Moreover, [fewer] than 10 people in the USA are reported as having rubella each year. Since 2012, all rubella cases had evidence that they were infected when they were living or traveling outside the USA.
To alert international travellers, the CDC issued a Level 2 Travel Alert regarding Japan's ongoing Rubella virus outbreak in August 2019. This "Practice Enhanced Precautions" Travel Alert says "travellers to Japan should make sure they are vaccinated against rubella with the MMR vaccine before visiting Japan." This CDC Travel Alert is important since approximately 4.5 million US citizens visit Japan annually.
Additionally, the Public Health Agency of Canada and the UK Foreign Travel Advice recommend "pregnant women who are not protected against rubella avoid traveling to Japan."
In the USA, there are 2 approved rubella vaccines: MMR II-Rubella and ProQuad. Both rubella vaccines are available at most pharmacies. Travelers to Japan can request a rubella vaccine counselling appointment with a local pharmacist.
Rubella vaccines, like any medicine, can produce side effects. [People] are encouraged to report vaccine side effects to a healthcare provider or the CDC. [Byline: Dani Reiter]
[See discussion of rubella in ProMED-mail Rubella - Japan (02)