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A Cautionary Tale on German Measles


René F. Najera, DrPH

May 16, 2021

Below, you'll find an embedded audio player for the episode "" from the . The podcast is a series of stories from history aimed at teaching us something about how big mistakes came to be and what we can do today to avoid making similar mistakes. In the episode embedded, we learn about a movie star who had a fateful encounter with someone in 1943. That encounter shouldn't have occurred, but it did because of a selfish thoughtless act.

German measles () is a viral disease that is usually self-limited disease that causes fever and a rash. It is normally not very dangerous for children, though there can be severe cases. The public health threat from German measles comes when it strikes pregnant women. The fetus is at very high risk of developing (CRS), a syndrome in which the fetus can be stillborn or born with a variety of malformations and ailments.

One woman who contracted German measles while pregnant was . Miss Tierney was a Hollywood star back in the late 1930s. In 1943, she contracted the disease from a fan who violated quarantine to meet her and then delivered Daria, a little girl born with CRS resulting in cataracts, deafness and developmental delay.

According to the Centers for Disease Control and Prevention (CDC):

The link between congenital cataracts and maternal rubella infection was first made in 1941 by an Australian ophthalmologist, Norman Gregg, who had noticed an unusual number of infants with cataracts following a rubella epidemic in 1940. In the absence of vaccination, rubella was an endemic disease with epidemics occurring every 6–9 years. If rubella infections occurred among nonimmune pregnant women, CRS cases occurred. During the 1962–1965 global rubella pandemic, an estimated 12.5 million rubella cases occurred in the United States, resulting in 2,000 cases of encephalitis, 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with CRS.
In 1969, live attenuated rubella vaccines were licensed in the United States. The goal of the rubella vaccination program was and continues to be prevention of congenital rubella infections, including CRS. In 2004, an independent panel of internationally recognized experts in public health, infectious diseases, and immunizations reviewed the available data on rubella epidemiology and unanimously agreed that rubella elimination (i.e., the absence of year-round endemic transmission) had been achieved in the United States. During 2005–2017, the number of reported CRS cases in the United States declined dramatically to <1 case per year (Centers for Disease Control and Prevention [CDC], unpublished data). Among the 15 CRS cases that occurred during this time, all but one were known importations (CDC, unpublished data). Of the 47 CRS cases occurring during 1998–2017, the mother was born outside the United States in 41 (89%).

In the podcast episode embedded below, the story of Miss Tierney's experience is narrated along with voice actors and additional information on what happened. The host, , also talks about other examples of people violating quarantine and what their motivations might be.


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