Rubella spreading rapidly among young men in Tokyo

TOKYO – Rubella, or German measles, has been spreading rapidly, especially among males in their 20s to 40s living in the Tokyo metropolitan area, prompting the health ministry to issue a call for citizens to get vaccinated against the disease.

According to the Health, Labor and Welfare Ministry, 1,656 cases of rubella have been reported this year, chiefly from the Kanto region. This is at least 20 times higher than the figure reported during the corresponding period last year.

The fast spread is chiefly due to a low rate of vaccination among males in their 20s, 30s or 40s, who account for about 70 per cent of the cases reported.

If a pregnant woman gets infected with the disease, there is a possibility of her baby suffering from serious congenital disabilities, prompting the ministry to urge men with pregnant wives to get vaccinated.

According to the ministry, rubella cases have been rising since the latter half of 2012. In the past three weeks, more than 200 cases have been reported every week.

Signs show the disease is spreading particularly in Tokyo and neighbouring prefectures, with the reported cases as of March 10 totaling 755 in Tokyo, 205 in Kanagawa, 139 in Chiba and 132 in Saitama.

The ministry said it fears the spread of rubella will compare to 2004, when an estimated 39,000 cases were reported.

Rubella is often perceived as a disease affecting children. However, lately about 80 per cent of victims have been men, with nearly nine out of 10 patients being in their 20s to 40s.

The routine vaccination against rubella started in 1977 and was targeted at middle school girls. Such a vaccination for boys was not implemented until more than 10 years later, leaving a high number of males unvaccinated.

The ministry warns that extra care is needed to avoid infecting pregnant women. If they are infected with the disease, their babies may develop congenital rubella syndrome (CRS), which can cause such serious disabilities as cardiac disorders, cataracts and hearing defects. There has already been one such case confirmed this year, the ministry said.

In light of the threat, the ministry sent a notice to local governments across the country in late January and late February, urging them to call on men with pregnant wives to get vaccinated.

Meanwhile, the prefectural government of Chiba and the city government of Kawasaki have made their own efforts, such as creating posters and leaflets and distributing them to local medical institutions and chambers of commerce. But the desired effect has not been achieved.

The low rate of vaccination is said to be primarily due to the high cost. If taken as a measles-rubella (MR) vaccine, the vaccination costs about 10,000 yen (S$130), and if taken individually it runs about 6,000 yen.

The Tokyo metropolitan government began this month giving subsidies to men with pregnant wives, on the condition that the local governments of their municipalities already have a subsidy system in place.

But only seven municipalities in central Tokyo have met such requirements among all municipalities in the area.

No subsidy system exists in Kanagawa, Chiba and Saitama prefectures, where many cases have also been reported. An official of the Kanagawa prefectural government said, “If the number of cases rises significantly, we’ll look into the possibility of such subsidies.”

Tomoyoshi Sonobe, a doctor and adviser to the Japanese Red Cross Medical Center in Tokyo, said: “Primarily, the central government ought to provide the subsidies, as it failed to include males in the routine vaccination from the start. But we can’t afford to wait for the central government to make a decision.

“Not only the metropolitan government but also other prefectural governments should consider granting subsidies.”

The number of rubella patients tends to rise from early spring until summer.

Keiko Taya, a doctor at the National Institute of Infectious Diseases, said: “The infection is starting to spread around the country. To prevent it from spreading further, I hope people will do what it takes to get vaccinated.”

Pregnant women at high risk

Programs to encourage the husbands of pregnant women to get the rubella vaccination have begun in Tokyo, where the nation’s largest number of patients has been reported.

“Pregnant women can’t get vaccinated. Their husbands, who are closest to them, should get vaccinated to protect their babies,” said Kayo Matsumoto.

Matsumoto is a doctor and head of the department to prevent infectious diseases at the Setagaya Ward Office and spoke during a class for expecting parents held earlier this month at the ward’s Karasuyama branch. It takes two weeks for a rubella vaccination to take effect. When Matsumoto urged the participants to get vaccinated as soon as possible, one expecting father, 37-year-old Hiroyuki Mizukami nodded, saying, “I’d like to get vaccinated soon.”

An increasing number of husbands are coming to hospitals to get vaccinated on the weekends.

A 29-year-old company employee who on March 9 visited a clinic specialising in internal medicine and pediatrics in the ward said: “I came here to get vaccinated because my pregnant wife doesn’t have enough immune defences [to prevent the disease]. We’d like to avoid risks as much as we can.”

Koji Yoshikawa, vice director of the clinic said, “Although the issue has become in focus recently, the number of people who are actually visiting clinics to get vaccinated remains low.”

“I hope people don’t regret not visiting clinics,” Yoshikawa said.

Source: The Yomiuri Shimbun/Asia News Network

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