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4. 5. Age............................................... 6. 7. 8. 9. 10. Socioeconomic Status 5. I 1. Other Factors 6. 1. 2. 3. Airborne Spread..................................... 4. 5. Vectors............................................ 6. Animal Reservoirs 7. Pathogenesis and Immunity 7. 1. Pathogenesis........................................ 2. 1. Control Program. . . . . . . . . . . . . . . . . . . 2. Immunization Concepts and Practice. . . . . . . . .

Second, the host response to many infections may result in disease in only a small percentage of those exposed or even of those infected, thus requiring a large volunteer group. Medically, there is concem for the seriousness of the disease produced and for the possibility, however remote, of permanent disability or even death. Finally, the moral and ethical right to use human subjects in any medical experimentation is under debate. In today's climate, experimental studies in volunteers are subject to very strict control, and work being supported by govemment, foundation, or institutional funds must be scrupulously reviewed by a committee of professional and sometimes of lay and religious representatives.

1. Incidence and Prevalence. . . . . . . . . . . .. . . . .. . .. . 2. Epidemic Behavior.. 3. Geographic Distribution. . . . .. . . . . . . . . . . 4. Temporal Distribution 617 617 618 618 618 618 618 619 619 619 620 621 621 Contents 6. 7. 8. 9. 10. 11. 12. 5. 6. 1. 2. 1. 2. 3. Rubella Vaccination Strategies: Their Impact on Rubella and Congenital Rubella .. . .. . .. . . . . .. . . . . 4. Vaccination during Pregnancy. . . . . . . . . . . .

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