Nearly 60 cases of rubella have been reported in Idaho in the past several months - the largest outbreak of the malady in more than a decade.
A woman who contracts the disease in the early stages of pregnancy risks miscarriage or a child born mentally retarded, physically handicapped, deaf or blind."Out of this outbreak, we've already had a tragedy," said Bob Medlin, state immunization coordinator. A first-trimester miscarriage has been linked to the mother's illness, he said.
The largest outbreak - 33 cases - is at Mountain Home, 37 miles east of Boise. Possible Boise cases have been investigated but not confirmed.
Women who are planning a pregnancy are being advised to have their blood tested to determine whether they are immune. "It is, as far as I'm concerned, one of the most necessary things a woman can do who is planning a pregnancy," Medlin said.
If tests show a woman is not immune, she should have a vaccination and then postpone pregnancy for 90 days, he said.
Dr. Jerry Hirschfeld, president of the Idaho Pediatric Society, recommends immunizations for all - children and adults alike - who have not had the illness or the shot, which has been available only since the early 1970s.
"The reason it's important to immunize everyone is so we don't give it to a pregnant woman who is susceptible," he said.
"A lot of these children are not spontaneous abortions, and they are born with significant birth defects . . . which will be with them the rest of their lives."
A woman who gets rubella during the first six to eight weeks of pregnancy has at least an 85 percent chance of having a miscarriage or delivering a child suffering from "congenital rubella syndrome."
Risk plummets to 10 percent in the second trimester - the third through sixth month of pregnancy - and to virtually nil if the illness is contracted in the third trimester.
Idaho's recent outbreak is afflicting mainly older teenagers and young adults, in keeping with a nationwide trend. "A lot of people missed the vaccine when it first came out," Medlin said.
"There's every reason to believe we have a larger group of susceptibles in older people than we would with our school-age children."