Travel Alert as Japan Struggles to Contain Outbreak of Rubella

Japanese man coughing with mask on
Photo by AH86/iStock/Getty Images Plus/Getty Images

by Julian Ryall, The Telegraph, December 12, 2018

More than 2,000 people in Japan have been diagnosed with rubella, or German measles, the worst outbreak in five years, prompting warnings to visitors – particularly pregnant women – to make sure their vaccinations are up to date.

The 2,454 cases that have been confirmed as of early December is 21 times the total number reported last year, with the outbreak centered on Tokyo and the surrounding prefectures of Kanagawa, Chiba and Saitama, according to the Atlanta-based Centers for Disease Control and Prevention.


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There is also growing concern that similar outbreaks in the next two years – Japan hosts the Rugby World Cup in 2019 and the Olympic Games will be staged in Tokyo the following year – could expose tens of thousands of foreign visitors to the disease.

Rubella, which is also known as three-day measles, is spread through the coughing and sneezes of people who are already infected. The symptoms include a rash, sore throat, fatigue and a fever that typically lasts three days.

And while the illness is often relatively mild, complications can include bleeding problems, testicular swelling and inflammation of the nerves.

At a glance | Rubella

Women in the early stages of pregnancy are particularly at risk and a mother can pass in congenital rubella syndrome (CRS) to her unborn baby. Symptoms of CRS include defects in the heart, eyes, brain and hearing. Infection can also lead to premature birth, low birth weight, anemia and hepatitis, while many mothers who contract rubella within the critical first trimester either have a miscarriage of a stillborn baby.

“We believe that the first cases were brought into Japan from abroad, but the system of regular vaccinations were introduced for female junior high school students in 1977,” an official of the National Institute of Infectious Diseases told The Telegraph.

The vaccination remained optional until April 1993, with many male students not having the injection. As a result, the latest outbreak is mostly affecting men between the ages of 30 and their early 50s.

The Japanese government on Tuesday reacted to the outbreak by announcing that health authorities will offer free rubella vaccinations for the next three years for men between the ages of 39 and 56 who were not vaccinated under previous health programmes.

A number of local governments and some companies have started offering free antibody tests or vaccinations, although health officials say there is still limited public knowledge of free immunisation schemes.

An official of the institute was quoted in the Mainichi newspaper as saying that more needs to be done to increase the number of people who have been vaccinated in order to “prevent a pandemic”.

US health authorities are recommending that anyone travelling to Japan ensure they have had the MMR (measles, mumps and rubella) vaccination before arriving.

Pregnant women who are not protected against rubella are being told to avoid travelling to Japan for the duration of the outbreak.

Studies indicate that vaccination is 95 percent effective, while the UK immunisation programme enabled authorities to declare that the illness had been eradicated in Britain in 2016.

In the last major outbreak in Japan, 16,000 people were diagnosed with the illness, with 45 babies suffering disabilities. Of that total, 11 subsequently died.

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This article was written by Julian Ryall from The Telegraph and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to [email protected]

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