Rubella Outbreak Taking Toll on Newborns : Health: Cases are running far ahead of last year’s county total. It can cause birth defects if contracted during pregnancy.

An epidemic of rubella--a mild respiratory illness that can cause birth defects if contracted during pregnancy--has swept Orange County and the state this year, and the disease is taking its toll on babies, public health officials said Wednesday.

Earlier this year, an Orange County baby was born with cataracts after his mother contracted rubella during pregnancy, and Los Angeles health officials suspect eight babies born there since June have rubella-related birth defects.

The incidence of rubella in Orange County and statewide appears finally to be waning, with just six cases reported in all of California in September. But public health officials said this was probably a seasonal drop and cases may rise again in January.

California health officials have reported 521 cases between Jan. 1 and Oct. 31, compared with 160 in all of 1989.

Overall, Orange County’s cases are running more than “five times ahead of last year’s,” said Dr. Hildy Meyers, epidemiologist for the Orange County Health Care Agency. Through September, doctors here reported 73 rubella cases compared with only 11 last year.

The outbreak has been worst in Stanislaus County, Southern California, the San Francisco Bay Area and the Central Valley, said Dr. Loring Dales, chief of the immunization unit at the California Department of Health Services.

In these areas, local health officials have battled seven rubella outbreaks in jails or prisons, he noted. In April, 28 Orange County jail inmates contracted rubella.

Concerned about the epidemic, Dales in October issued a statewide alert to pediatricians, asking them to watch for “congenital rubella syndrome.”

“We had this upsurge” of rubella cases, particularly from March to June, Dales said. “We expect rubella babies in early October.”

For children and adults, rubella--also known as German measles--is usually a mild disease, characterized by painful lymph nodes, a rash that lasts one to three days, joint pains and unusual sensitivity to light.

But mothers who contract the disease during pregnancy pass it on to their fetuses. The outcome, especially when the mother contracts rubella during the first five months of pregnancy, can be grim. Babies may be born with cataracts, glaucoma, mental retardation, deafness, heart defects and a high incidence of diabetes--and in some cases, the babies may not survive.

It could be easy to miss the fact that a child with a birth defect was exposed to rubella in the womb, Dales noted.

“If a child is born with a moderate hearing loss, you might never think back, ‘Oh, boy, this is from the rash I had in pregnancy,’ ” Dales said.

Dales also warned that babies born with congenital rubella syndrome “keep shedding the virus up to a year, a year and half,” so pediatricians need to watch for these children and make sure they do not infect others.

State and local health officials say they do not know the cause of this year’s outbreak. Unlike the statewide measles epidemic, which has hit Latino families hard, this outbreak appears to affect nearly all ethnic groups equally, Dales said.

He noted one exception--fewer cases involve blacks. But he added, “the darker your skin, a mild infection, a mild rash is hard to track.”

About 70% of the cases involve adults between the age of 20 and 40, and the rest are preschoolers, Dales said.

While state health officials are concerned about the rubella outbreak, it still pales when compared to the continuing statewide measles epidemic--a longer-lasting, more severe infection that can cause brain damage and death. So far, California’s measles epidemic has resulted in 12,000 measles cases and 55 deaths, two in Orange County, Dales said.

RUBELLA EPIDEMIC

California is in the midst of an epidemic of rubella, also known as German measles. If contracted during pregnancy, the disease can cause numerous birth defects, including mental retardation, diabetes and deafness. The epidemic appears to be waning, however. The number of cases reported each month has steadily dropped since June.

Year Reported Cases 1990 521 1989 160 1988 85 1987 140 1986 242 1985 138 1984 195

Source: California Department of Health Services