A Large Rubella Outbreak With Spread From the Workplace to the Community

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Abstract
Between March 23 and 26, 1999, a 29-year-old man residing in Douglas County, Nebraska, sought treatment in 3 health care facilities for what he thought was a sexually transmitted disease. At his third visit, he was noted to have a maculopapular rash, low-grade fever, and lymphadenopathy. Though no case of rubella had been reported in Douglas County in the previous 9 years, the patient had a positive rubella IgM test result. The patient worked in a meatpacking plant where a second rubella case was identified. Surveillance for rash illness was enhanced, resulting in the detection of more individuals in other meatpacking plants and in the community, almost all of whom were young adults born in Latin American countries, where rubella vaccination only recently has been implemented for children.