Congenital Rubella Syndrome

I hinted at this story in a chapter of “The Poxes”. What you are about to read is real. It really did happen. However, due to privacy concerns, I will not disclose some of the information like the real name of the person, where they lived, where they travelled, etc. It is also not meant to scare you into getting a vaccine or not traveling to a part of the world where there is a lot of a vaccine-preventable disease. The main aim of this story is to let you know that these things happen, and they are happening at a higher rate than any vaccine injury you can think of. Also, “The Poxes” is on hiatus. I’m working with a colleague who is better at writing than I am to refine the story and expand it into a good, gripping tale for you all to read. My version ended in two more chapters. The ideas we’ve been tossing around take us into about 30 chapters with the same conclusion I had in my head, only with more blood and guts. So stay tuned for that. Until then, I give you Stacy’s story. (Again, that’s not her real name.)

Stacy was a young woman from a well-to-do family in the suburbs of northern Virginia. She was well-educated, somewhat religious, and she always wanted to travel abroad. Stacy met a young man in college and they both found out that they had a calling in their hearts to help less fortunate people in other countries. For their wedding, their friends and family got money together and, along with their church, bought them a honeymoon in a third world country on the other side of the world. They would get to see exotic places and animals for a couple of weeks then buckle down and work for the people there for an additional three months. Stacy was ecstatic.

Six weeks into their trip, Stacy noticed that her period was late. A quick trip to a larger city near the village where they were staying confirmed that she was pregnant. Because prenatal care was sort of rustic, Stacy’s family implored her to return to the States. She told them that her heart was telling her to stay and that she was only going to be there another two months anyway. If anything were to happen, the plan was to take her to the city and fly her to a more developed nation as soon as possible. Two weeks later, a young woman came to their church with a fever and a strange rash over her body. Stacy was one of the people who took her to the city in a car.

Two days after that, Stacy received a visit from a doctor from the city. The doctor was in the village with a group of public health workers from the government. They were there to vaccinate the village with the MMR vaccine since the young woman was found to have German Measles. Stacy and her husband both refused the vaccine. Her husband was vaccinated as a child and, according to him, he had a “vaccine injury”. Stacy grew up in a family and belonged to a church that discouraged vaccination. When the doctor found out that Stacy was pregnant, he told her all about Congenital Rubella Syndrome. He had seen plenty of cases of children with deformations, blindness, deafness, and stillbirths because of it. Stacy prayed about it for a bit, called her parents in the States, and she refused the vaccine. God, her health, and her diet were going to protect her baby. Her parents assured her of it.

Stacy finally returned to the States and almost immediately went to see an obstetrician. An ultrasound revealed that her child had heart defects. Her blood tests came back positive for exposure to German Measles. That finding was significant since she was not vaccinated. All that Stacy remembered as far as an illness were one or two days of feeling sick to her stomach, maybe a slight fever, a swollen neck gland, but no rash. And it happened weeks after the girl was sick, so Stacy thought nothing of it. Based on the ultrasound findings and the blood tests, it was recommended to Stacy and her husband that they consider terminating the pregnancy. They refused on religious grounds.

Stacy’s baby was born with cataracts over its eyes, several heart defects, and a smaller-than-average head. The baby died ten days after birth from the complications of the heart abnormalities.

It may seem like these things happen in far away places to undesirable/unlucky/unfortunate people, but, because of the way that we live and travel, it can happen right here, right now, to anyone in the most powerful nation in the world. Whatever your fears are about vaccines and their safety, they are tiny in comparison to the horrors that thousands of women like Stacy go through in other parts of the world. If you’re a pregnant woman who is unvaccinated, please consider getting vaccinated. If you’re traveling abroad, please get all of your recommended vaccines as well.

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21 thoughts on “Congenital Rubella Syndrome

  1. Hi Chemmomo, receiving MMR within 72 hours of wild-type exposure can protect the recipient from disease so if the vaccine was offered within that time then theoretically, it may have prevented full infection. This is also a situation where the small risk of vaccination, even with a live viral vaccine would outweigh the risks of omission. There have been studies that have demonstrated that vaccination of pregnant women with MMR never conferred congenital rubella syndrome in any of the children even though viral RNA fragments could be recovered and IgM titres present.

  2. This story is so heartbreaking.

    I wonder if Stacy will change her mind and get an MMR now, or will she continue to put her future children at risk even though she knows the consequences?

    • Chemmomo: well, since she had rubella, she’s protected from that (I had rubella as a young girl and was still immune in my 20s and 30s when tested). So she won’t have at risk children for congenital rubella. Measles or mumps now…

  3. I’m pregnant now and recently learned I lost my immunity at some point over the past 2.5 years (I had immunity when I was pregnant with my son). Thy do not recommend the vaccine for pregnant women as it is a live vaccine.

    • Lisa: that’s interesting. I wouldn’t have thought immunity would wane that fast – but I’m guessing you had the vaccine and not the disease? You may still be somewhat protected, though, just not high enough titers to be considered “immune”. And you can get the vaccine after delivery.

  4. poor Stacy should have gotten the MMR before travelling abroad as part of her travel preparations. My mother had a colleague with a daughter who had full blown CRS, blind, deaf, complicated heart defect, intellectual disability and cerebral palsy. We (DH and I) met her once when she was a preteen – a much loved, very very very ill young girl. Mom had been told that her daughter would not survive the third heart surgery scheduled for her early teens for very long, however, she did, is now in her 40ies and living in an institution. Rubella vaccination would have given her a very different life. Thank you for writing this down, Reuben.

  5. I have a question. At the point we are talking about, she was already pregnant. I thought she should not get the MMR anyway at that point (the problem, if that’s the case, was that she was not vaccinated earlier). Am I wrong?

    • Yes. She was pregnant sometime before or immediately after arriving abroad. Her exposure was in the first trimester. Had she been vaccinated, the chances are extremely good that this could have been avoided. From what I heard from colleagues in that country, they lost a lot of pregnancies as the epidemic went through the village.

    • Does the fact that she was exposed to the wild type disease matter? Could the receiving the vaccine lower the risks of the full blown disease damaging the pregnancy? I understand why you don’t want to add the risk of a live virus vaccine for a woman who might get pregnant where the disease is not circulating, but that’s not what happened in this case.

      Could the vaccine have helped? There were (as noted in another comment) other pregnancies affected by this rubella outbreak. Did any of those women receive the vaccine? Or did all the pregnant women reject it and take their chances with the wild type? Is there any data on the effects of vaccine strain vs the effects of wild rubella on pregnancies?

      • I don’t know about the effects of wild vs vaccine. I’m sure the risks from the vaccine are less since the virus is attenuated. I’ll look it up.

        The women in the village didn’t refuse the vaccine. They lived in a part of the world where the vaccine is not readily available and when outbreaks happen they try to contain it with vaccines.

        I wish I could share more details. Sorry.

      • Hi Chemmomo, receiving MMR within 72 hours of wild-type exposure can protect the recipient from disease so if the vaccine was offered within that time then theoretically, it may have prevented full infection. This is also a situation where the small risk of vaccination, even with a live viral vaccine would outweigh the risks of omission. There have been studies that have demonstrated that vaccination of pregnant women with MMR never conferred congenital rubella syndrome in any of the children even though viral RNA fragments could be recovered and IgM titres present.

  6. I was wondering about The Poxes. I can’t wait for a finished product!

    As for this case, God, her health, and her diet were going to protect her baby from having to try to survive having idiots for parents.
    At least they didn’t manage to share the disease with the elderly or young too young for an MMR vaccination first, they did manage to keep it at home with them. That is more than I can say for some other antivax idiots out there.

    As for both cases, I honestly believe that they should be held criminally liable for any injuries that they pass along. For antivaxers, for any who they infect and for the former, for the baby that they could have protected.
    The only real question is what should the punishment be? Life in prison or mandatory sterilization?

    • WZRD1, I wrote elsewhere about liability for others, but as for the baby, there is a potential claim there in about half the states. In the other half, parents are immune from tort liability for their medical choices. And those claims are rarely brought anyway, because the parents are the ones who bring the claim.
      Criminal liability is even trickier. Do you want me to go into this in more detail?

      • In this case, I see the grandparents of the dead child at fault, not the parents. They were the ones who originally refused the vaccine for Stacy, and turned her against protecting her own child through vaccination.

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