Rubella in Panama: still a problem.

In 1986 there were 3795 cases of acquired rubella reported in the Republic of Panama (177/100,000 population) of which 1550 were from the Metropolitan Region (261/100,000 population). Fifty-four neonates (218/100,000 of those born alive), born predominantly in two medical centers within the capital, were identified with compatible or confirmed congenital rubella manifesting as cardiopathies and neurologic defects in 68.5%; low birth weight in 61%; ocular defects in 48%; muscular tone alterations and psychomotor retardation in 35 and 33%, respectively; and hearing loss and purpura in 29.6%. It is estimated that the annual direct cost of care for these 54 patients would be close to $123,730, and this confirms the high cost of continuing care compared with the use of a safe, economical and efficient vaccine.