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The remarkable contribution of vaccination programs to public health cannot be contested. The success of Jonas Salk’s polio vaccine in mass human trials, the fiftieth anniversary of which was celebrated on April 12, 2005, was one of the most important feats in the history of medicine. As a result of this prevention strategy, the devastating epidemics that plagued the country in the twentieth century have not since occurred, and the World Health Organization declared the US polio-free in 1994. With this announcement, polio was added to the list of diseases that have been stamped out through successful, widespread vaccination programs: the global elimination of smallpox was declared in 1979, and in 2000, measles was pronounced no longer endemic in the US.
Rubella (also known as German measles) followed suit on March 21, 2005, when the Centers for Disease Control (CDC) declared it eliminated in the US. The rubella virus was once a grave health threat to infants and a major cause of serious birth defects and miscarriages. The CDC embarked on a rubella elimination program in 1989, and in the following decade, only 117 cases were reported. In 2001, for the first time, fewer than 100 US cases were reported, and in 2004, fewer than 10 cases surfaced, all of which were likely acquired in other countries and imported into the US.
Despite extraordinary progress in relegating vaccine-preventable diseases, such diseases endure, predominantly in developing countries. Vaccinations against rubella will continue vigilantly in the US because international travel to areas without steadfast vaccine programs makes it possible for surreptitious cases to enter the country and transmit the disease to vulnerable individuals. The Pan-American Health Organization has set a goal to eliminate rubella from all of North and South America by 2010.
Figure 1
Infant with "blueberry muffin" skin lesions indicative of rubella, a major cause of serious birth defects, which has been eliminated in the US. Photo courtesy of the Centers for Disease Control.