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News Update from the Ministry of Health

29^th October, 2002

 Tonga to Launch National EMERGENCY Rubella Immunization Campaign on November, 2002

Tongan Government through its Ministry of Health will implement in November 2002 the National Emergency Rubella Immunization Campaign.

This campaign will use measles-rubella (MR) vaccine and target all people ages 1-19 years, and females only from the ages 20-44 years, omitting all females whom are pregnant and those who plan to be pregnant within the next 3 months. These pregnant mothers and potentially expectant mothers can be given their MR vaccines after delivery but before being discharged from the hospitals.

Rubella, otherwise referred to as the German measles, is a mild and highly contagious illness that is caused by a virus. It is characterized by rashes, swollen glands behind the ears and back of the head, and especially in adults, with joint pain. The rashes usually last about three days and may be accompanied by a low fever. Other symptoms such as headache, loss of appetite and sore throat are more common in infected adults and teenagers than in children.  Sometimes there are no symptoms at all.

Rubella virus is a totally different virus than that that causes regular measles (Rubeola or otherwise called the English Measles), even though how they are presented in an affected person may be very difficult to differentiate unless a blood sample is sent for analysis for the virus. Immunity to Rubella does not protect a person from Measles or vice versa.  But once a person contracted the Rubella or Measles they are immuned for life.

The Emergency Campaign was indicated after close evaluation of the alarming impact of the Outbreak in relation to the number of children affected by encephalitis (inflammation of the brain) caused by Rubella virus; about 30% of pregnant women were not protected from the virus; and the fact that Tonga has achieved a high percentage coverage (95%) of Measles makes it very possible that if Rubella vaccine can be co-operated into the routine vaccination campaign, Tonga will in years to come will achieve likewise.  The data collected so far had shown an outbreak in every 6 years since 1990, 1996 and now 2002.  All these findings were tabled for discussion by the National Health Development Committee earlier this month, and later submitted to Cabinet for information and endorsement. A WHO Consultant was also recruited to assist the Ministry of Health with its monitoring and planning of activities to manage the outbreak.

This Outbreak as from the report from the Hospital (Vaiola Hospital), Health Centre and Community survey started in April 2002.  To date, there were 40 cases of clinical encephalitis, and 35 of those were confirmed to be due to Rubella virus.  There were 36 cases 14 years and below, and 4 were between 15-24 years of age.   Many adults have been reported with rubella and undoubtedly many more have been affected and exposed, including pregnant women.

Unborn babies whose mothers contracted with rubella during the first 3 months of pregnancy are most at risk (85-90%) of being affected with one or more birth defects. These birth defects include eye defects (resulting in vision loss or blindness), hearing loss, heart defects, growth and mental retardation and, less frequently, cerebral palsy.

The worst worldwide out break of rubella was in the USA in 1964-65 with more than 20,000 babies were born with birth defects. The same outbreak also resulted in at least 10,000 miscarriages and stillbirths. 

Issued on the 29^th October, 2002

Ministry of Health

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