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Rubella in Universities -- Washington, California.
Seattle, Washington: Between April 4 and May 3, 1981, 12 cases
of
rubella were reported among students at the University of
Washington
in Seattle. Eight cases were serologically confirmed as rubella by
a
four-fold or greater rise in hemagglutination-inhibition (HI)
antibody
titer. The students' ages ranged from 21 to 30 years with a mean
of
23 years, and six students attended the same drama class. Nine of
the
12 students were female; one, who contracted rubella in her first
trimester of pregnancy, chose to have an abortion. No specific
control measures were instituted in this outbreak, nor was the
index
case ever identified. The University of Washington does not
require
students to prove immunity to rubella before enrollment.
Los Angeles, California: In late November 1981, 10 cases of
rubella-like illness were reported among students seen at the
University of Southern California student health center. The
illnesses were characterized by maculopapular rashes lasting 3-5
days,
low grade fever, malaise, arthralgia, and conjunctivitis. Between
November 1981 and January 20, 1982, 49 students developed a similar
illness, with the peak occurring between November 15 and December
15;
two cases were serologically confirmed as rubella. The students'
ages
ranged from 18 to 34 years with a mean of 21.5 years. Sixty-seven
percent of affected students were male; 30% lived in university
dormitories or apartments; and 38% were enrolled as business
majors.
The University of Southern California, which does not require proof
of
immunity to rubella, did not implement a control program.
Berkeley, California: Between December 21, 1981, and March 23,
1982, 17 cases of rash illness were reported among students at the
University of California-Berkeley. Eleven of the cases were
serologically confirmed as rubella. The students, who ranged in
age
from 20 to 34 years, had a mean age of 28.7 years. Twelve of the
affected students were male. Although one student was initially
hospitalized for diagnostic purposes, no nosocomial spread of
rubella
occurred. No pregnant students or contacts were identified. The
majority of ill students resided in a cooperative residential hall
(190 residents). Although rubella cases are reported routinely
among
students at the University of California-Berkeley, no proof of
rubella
immunity is required for admission.
Reported by J Altman, MD, Student Health Svc, University of
Washington, D Hoyt, A Cronin, J Frederickson, C Nolan, Seattle-King
County Health Dept, J Allard, PhD, State Epidemiologist, Washington
State Dept of Social & Health Svcs; J Chapman, MD, Student Health
Svc,
University of California-Berkeley, L Dales MD, AJ Ebbin, MD,
Student
Health Svc, University of Southern California, L Habel MPH, B
Weiss,
MPH, M Strassburg MD, S Fannin, MD, Los Angeles Dept of Health
Svcs, J
Chin MD, State Epidemiologist, California State Dept of Health;
Immunization Div, Center for Prevention Svcs, CDC. Editorial Note
Editorial Note: These reports demonstrate the potential for
rubella
outbreaks among university students. An estimated 10%-20% of
persons
greater than or equal to 18 years of age remain susceptible (1).
Since many students and university personnel are of child-bearing
age
and some may be pregnant at the time of an outbreak, rubella can
pose
a serious public health problem.
Although rubella immunization is required for school entrance
or
attendance in all states, female students greater than or equal to
12
years old are exempted in many states because of the theoretical
risk
to a fetus associated with vaccinating pregnant women. Existing
data,
however, show this potential risk, to be minimal (2). Because of
continued rubella outbreaks on campuses and exposure of pregnant
students, university employees, and contacts, universities should
address the issue of rubella immunity among students and staff
(3-6).
The Immunization Practices Advisory Committee (ACIP) strongly urges
educational institutions to consider requiring proof of immunity
(documented history of rubella vaccination on or after the first
birthday or presence of antibody to rubella) for admission or
employment (2). Both male and female students should be included
in
any such requirement.
References
Dales LG, Chin J. Public health implications of rubella
antibody
levels in California. Am J Public Health 1982;72:167-72.
ACIP. Rubella prevention. MMWR 1981;30:37-42,47.
CDC. Rubella in Wisconsin--an outbreak on a college campus.
In:
Rubella surveillance report, January 1976-December 1978.
Atlanta:
CDC 1980:20-2.
Guyer B, Giandelia JW, Bisno AL, et al. The Memphis State
University rubella outbreak. An example of changing rubella
epidemiology. JAMA 1974;227:1298-300
Strassburg MA, Marquard JL, Fannin SL, Greenland S. Rubella on
a
university campus: an evaluation of case immunity histories.
Nurs
Res 1980;29:390-1.
Chretien JH, Esswein JG, McGarvey MA, deStwolinski A. Rubella:
pattern of outbreak in a university. South Med J
1976;69:1042-4
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