CDC Alert - Level 2, Practice Enhanced Precautions

Japan’s Rubella Outbreak Earns CDC Travel Alert

CDC Level 2, Practice Enhanced Precautions Travel Alert Issued for Japan
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Japan (Precision Vaccinations News)

Travelers to Japan should make sure they are vaccinated against rubella with the MMR (measles, mumps, and rubella) vaccine before travel, said the Centers for Disease Control and Prevention (CDC) in a travel alert on October 22, 2018. 

This Level 2, Practice Enhanced Precautions alert said ‘Rubella is very dangerous for a pregnant woman and her developing baby.’ 

And, ‘Pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak.' 

Rubella, also called German measles, is a disease spread by the coughs and sneezes of infected people. 

If a pregnant woman gets rubella virus, her baby could have birth defects such as deafness, cataracts (blurred vision), heart defects, mental disabilities, and organ damage, says the CDC. 

When rubella infection occurs during early pregnancy, serious consequences—such as miscarriages, stillbirths, and severe birth defects, congenital rubella syndrome (CRS), can result.   

"Congenital rubella syndrome can be a devastating congenital birth defect, which is easily prevented by ensuring complete coverage with the MMR vaccine," said Peter Hotez, MD, Ph.D., Dean, National School of Tropical Medicine, Baylor College of Medicine, and author of Vaccines Did Not Cause Rachel's Autism.     

Currently, health officials in Japan have reported an outbreak of rubella in the Kanto region, which includes Tokyo, Kanagawa, Chiba, and Saitama. 

As of October 7, 2018, a total of 1,103 Rubella cases have been reported in Japan this year. 

What can travelers to Japan do to protect themselves? 

  • Make sure you are fully vaccinated or otherwise protected against rubella
  • People who cannot show that they were vaccinated or are otherwise protected against rubella should get vaccinated before leaving the United States
  • Infants (6–11 months of age) should have 1 dose of MMR (measles, mumps, and rubella) vaccine. Children in the United States routinely receive MMR vaccination at age 12–15 months
  • Adults and children 1 year of age or older should have 2 doses of MMR vaccine separated by at least 28 days
  • Avoid contact with people who are sick

Additionally, women who are already pregnant cannot be inoculated as the MMR vaccine, as it may have a negative impact on the child, says the CDC. 

If a woman needs to get vaccinated for rubella, they should avoid becoming pregnant until 1 month after receiving the MMR vaccine and, ideally, not until your immunity is confirmed by a blood test. 

In the USA, 2 approved Rubella vaccines are available, MMR-II and ProQuad. 

Travelers to Japan can request a vaccine appointment with a pharmacy at Vax-Before-Travel. 

The CDC Vaccine Price List provides the private sector vaccine prices for general information. 

And, MMR vaccine discounts can be found here. 

Vaccines, like any medicine, can have side effects. You are encouraged to report negative side effects of vaccines to the FDA or CDC.


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