Heilbrigðisskýrslur - 01.12.1969, Page 92

1969
— 90 —
to the patient’s own doctor to use his discretion in the individual case
(Department of Health and Social Security, 1970b). Should a doctor
decide to offer vaccine under such circumstances it is desirable to have
a preliminary serological test which can be obtained through the Public
Health Laboratory Service; only those women found to be seronegative
to rubella virus should be considered for vaccination. It is important
to be sure that a woman is not pregnant at the time of vaccination or for
two months afterwards.
B.59. Routine vaccination was begun on lst September 1970, initial
priority being given to girls in their 14th year (i. e. aged 13 years). In
order to facilitate the vaccination programme in its early stages vaccine
was made available without cost to local authorities up to 31st March
1971. This was to enable them during that period to offer vaccination
to all girls in their 14th year (Department of Health and Social Secu-
rity, 1970c).
3.60. The aim of the vaccination programme is not to eradicate rubella
from the community, but rather to protect girls before they reach the
childbearing age, and thus to reduce and finally, it is hoped, eliminate
the risk of fetal abnormality due to rubella in early pregnancy. It has
been estimated that about 200 children are born in England and Wales
with congenital rubella defects in a non-epidemic year but, of course, the
number would be greatly increased following an epidemic. In order
to assess the effect of vaccination on the incidence of congenital ru-
bella defects a careful plan for maternal surveillance has been drawn
up by Dr. J. A. Dudgeon, the Hospital for Sick Children, Great Ormond
Street, London and Professor R. W. Smithells, Department of Paediat-
rics, University of Leeds at the behest of the Joint Committee on
Vaccination and Immunization. It is hoped that this plan, which is
essentially an extension of a scheme which is already being operated
by a number of paediatricians, will be inaugurated in 1971.“
Prófessor Margrét Guðnadóttir hefur látið í té eftirfarandi greinar-
gerð um bólusetningu gegn rauðum hundum:
Auk þess sem rubella-veira skaðar fóstur, ef móðir veikist á fyrstu
vikum meðgöngutíma, hefur rubella einnig valdið fósturskemmdum,
þar sem móðir hafði sjúkdóminn rétt áður en hún varð ófrísk.
Börn, sem fæðast með galla af völdum rubella-fóstursýkingar, skilja
veiruna út í þvagi og saur marga mánuði eftir fæðingu. Má finna
veiruna í vefjum þessara barna a. m. k. tveimur árum eftir fæðingu.
Þessi börn eru því smitberar. Þau fæðast þó með miklu magni af mót-
efnum, sem fóstrið sjálft hefur myndað in utero, en eru ekki komin
gegnum fylgju frá móður. Þessi mótefni koma ekki í veg fyrir útskilnað