A rubella outbreak among dental students: description of the outbreak and analysis of control measures

From February to April 1982, rubella was diagnosed in 17 Washington University dental students. The affected students represented 4.8% of all dental students and 21% of susceptible students. Because a high likelihood of rubella transmission was perceived, three adjacent university hospitals undertook an emergency program to ensure immunity to rubella in all personnel. The program reached 84.6% of all target personnel, but only 36% of physicians (p less than 0.001). We estimated that the program increased the level of rubella immunity from 92.2% to 98.1%, at a total cost of $140,274 of which $29,990 was in excess of ordinary expenditures. Our experience indicates that schools training health professionals face the possibility of rubella outbreaks unless they ensure rubella immunity in all students. The experience also supports the value of ongoing programs to ensure rubella immunity in hospital personnel. Without such programs, hospitals may be forced to undertake emergency programs that are likely to be disruptive and expensive and may have relatively little immediate measurable impact.