February 26, 1973

Rubella in an Immunized Island Population

Author Affiliations

From the Center for Disease Control, Public Health Service, Atlanta (Drs. Witte, Hattis, and Herrmann) and the Department of Tropical Medicine and Medical Microbiology, University of Hawaii School of Medicine, Honolulu (Dr. Halstead).

JAMA. 1973;223(9):1019-1021. doi:10.1001/jama.1973.03220090039008

Although the epidemiology of rubella virus has been studied in detail,1-8 the marked variation in epidemic potential of rubella virus in different population groups remains unexplained. The introduction of rubella into the highly susceptible population in Hawaii has seldom resulted in epidemic disease.9 In contrast, at the US Army recruit training camp at Fort Ord, Calif, rubella is endemic throughout the year and a very high proportion of susceptible men (including Hawaiian recruits) become infected during the short period of basic training.3,10 During the winter of 1970-1971, rubella was introduced into Kauai, an island community where the rubella immunity status had been accurately defined. This report summarizes the epidemiology of the outbreak and discusses some host-dependent factors that may be related to the epidemiology of this virus.

Materials and Methods 

Studied Area.—  Kauai is the fourth largest of the Hawaiian Islands (555 square miles). Its racially diverse