Staff Reporter

Thiruvananthapuram: Adolescent girls and young women of child-bearing age should be given MMR (mumps-measles-rubella) vaccination compulsorily to prevent the incidence of

rubella infection in future pregnancies, which can result in severe multiple defects in newborn babies, paediatricians have urged.

Though rubella is considered a mild viral disease, it is most dangerous for pregnant women, especially if they contract the infection in the first trimester of pregnancy.

Infants born to mothers who contracted Rubella during early pregnancy are born with congenital rubella syndrome (CRS), characterised by multiple defects such as heart diseases, hearing and vision impairment or mental retardation, experts said at a workshop on Paediatric and Adolescent Immunisation, organised by the city chapter of Indian Academy of Paediatrics here on Sunday.

MMR vaccine, though it was yet to be included in the universal immunisation schedule, was currently being administered by most hospitals to infants between 12 and 18 months of age.

However, most young women of the day of marriageable age or who were planning a pregnancy in the near future could be susceptible to rubella infection because MMR vaccine was not popular in the 1980s or 1970s and it was very much likely that they were not vaccinated during childhood, A. Santhoshkumar, Associate Professor of Paediatrics and the chief of the Neonatal unit, SAT hospital, said.

"Rubella infection results in damages to organs in a developing foetus, while in adults, its manifestation is mild and hardly lasts more than three days. We are immunising all new-borns against Rubella now as a long-term measure but there is a large number of non-immunised adults in the community," Dr. Santhoshkumar said.

Diagnosis of Rubella infection is often missed because it presents in a mild form and is often mistaken for viral fever or measles. In the SAT hospital, an epidemic of CRS was reported during October-December last year, when nearly 30 new-borns were admitted with the disease. Three babies with CRS could not be saved while about 20 of the infants had heart diseases.

The epidemic at SAT hospital should be seen as a direct consequence of the Rubella episode that was reported from the girls' hostel at Medical College campus in January-February last year when the hostel had to be closed down after several students were diagnosed with Rubella.

As the disease is air-borne, many pregnant women must have caught the infection, resulting in the subsequent epidemic at SAT hospital, it was pointed out.

The former president of IAP, M. K. C. Nair, said that IAP would recommend to the State Government to introduce compulsory MMR vaccination for all adolescent girls. The fact that only few cases of Rubella are being reported from the community should not be taken at face value because many congenital defects in babies, like hearing impairment, could be a result of Rubella infection in the mother, he said.

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