Rubella, congenital rubella more prevalent among foreign-born persons. (Hispanics are Hardest Hit).

The majority of rubella and congenital rubella syndrome cases reported in the United States now comprise foreign-born persons who are mainly Hispanic, said Dr. Susan E. Reef of the Centers for Disease Control and Prevention, Atlanta, and her associates.

The total incidence of rubella in the United States decreased from 0.45 per 100,000 in 1990 to 0.1 per 100,000 in 1999. During this period, the total number of reported cases ranged from an all-time low of 128 in 1995 to 1,412 in 1991 (JAMA 287[4]:464-72, 2002).

The incidence of rubella among Hispanic persons reached a high of 0.97 per 100,000 persons in 1998, up from 0.06 per 100,000 in 1992. Many of these Hispanic persons were foreign born.

In 1998, 79 of the persons with rubella with a known country of origin were born outside the United States; 91% were from a country in the Western Hemisphere.

Many of the foreign-born persons who have been vaccinated received their vaccinations within the 2 weeks prior to the onset of a rash.

"This finding demonstrates failure to vaccinate, not vaccine failure or waning immunity, to be the reason for rubella continuing in the United States," the investigators said. Young, Hispanic, or other foreign-born women tended to have the most infants with congenital rubella ...