Image copyright AP Image caption Health officials launched a wide vaccination programme throughout the Americas 15 years ago 
 
 North and South America have become the first regions of the world to eradicate rubella, or German measles, after no home-grown cases in five years. 
 
 The virus - spread by sneezes or coughs - can lead to serious birth defects if contracted by pregnant women. 
 
 Up to 20,000 children were born with rubella in the Americas every year until mass vaccinations started. 
 
 But the last endemic cases registered in the region were in Argentina and Brazil in 2009. 
 
 The fact no new cases have been declared in five consecutive years, apart from those imported into the region, allowed global health chiefs to declare the Americas free of the virus. 
 
 Eradication was "an historic achievement", said Carissa Etienne, director of the Pan-American Health Organization, which is part of the World Health Organization. 
 
 "The fight against rubella has taken more than 15 years," she said. "But it has paid off with what I believe will be one of the most important pan-American public health achievements of the 21st Century." 
 
 What is rubella? 
 
 Rubella is also called German measles. It is caused by a virus and spreads when an infected person coughs or sneezes. 
 
 Usually rubella causes a rash, a slight fever, aching joints, headaches, runny nose and red eyes. The rash starts on the face and spreads from head to toe. 
 
 Sometimes the lymph nodes behind the ears and on the neck can swell painfully. 
 
 Rubella can be dangerous for pregnant women in the first three months of pregnancy. 
 
 It can lead to congenital rubella syndrome (CRS) in children, and cause autism, blindness, deafness and heart defects. 
 
 Image copyright Science Photo Library Image caption Rubella, or German measles, causes a rash that spreads down the body 
 
 During the last major rubella outbreak in the region, between 1964 and 1965, close to 20,000 children were born with CRS in the United States. The country managed to wipe out the virus by 2004. 
 
 However, about 120,000 new cases of rubella emerge every year, particularly in south-east Asia and Africa. 
 
 An outbreak of measles - a highly contagious virus - infected 150 people in the US alone at the turn of the year, after spreading from the Disneyland resort in California. 
 
 Doctors blamed the outbreak on parents refusing to give their children the MMR vaccine - the same one that prevents rubella - due to fears about potential side-effects. 
 
 Before that outbreak, the US had been free of measles for 15 years. 

 WASHINGTON -- Smallpox was the first, in 1971. Then polio, in 1994. Wednesday, the Pan American Health Organization said two more diseases had been eradicated from the Americas: rubella and the similar congenital rubella syndrome. 
 
 Rubella, a virus also known as German measles, causes mild symptoms in adults and children, but severe birth defects and fetal death during early pregnancy. It affected 15,000 to 20,000 people a year in North America, Central America and South America prior to widespread vaccination, Dr. Cuauhtemoc Ruiz, Pan American Health Organization immunization unit chief, said at a news conference. A mother infected with rubella in early pregnancy can have a child born with congenital rubella syndrome. 
 
 Rubella was effectively eradicated from the United States around 2002, thanks to mass vaccination and public education. In 2009, Argentina experienced the Americas' last endemic cases of rubella, and Brazil had the final outbreak of congenital rubella syndrome. Public health experts consider a disease eradicated from a region once no endemic cases have been reported for at least three years. 
 
 If history is a guide, erasing rubella and congenital rubella syndrome from the Americas suggests the diseases will soon be eradicated from the planet. 
 
 The Americas was the first of the World Health Organization's six designated regions to eradicate smallpox. About a decade later, in 1980, the disease was eradicated worldwide. Polio followed a similar pattern, although a few hundred endemic cases are reported annually in Afghanistan, Nigeria, and Pakistan, so the disease isn't yet officially eradicated. 
 
 Replicating that success with rubella and congenital rubella syndrome will prove formidable, given the approximately 120,000 cases a year worldwide. 
 
 Dr. Susan Reef, a rubella expert at the U.S. Centers for Disease Control, said only two of the six WHO global regions, Europe and the Americas, have goals to eliminate rubella. "We need the four other regions to establish targeted elimination goals," she said. "So I can tell you it will not be before 2020" that the disease is eradicated globally. 
 
 Ruiz said the next goal was to eliminate rubella in the European region by the end of 2015, and in the Southeast Asia region by 2020. The other three regions -- African, Eastern Mediterranean, and Western Pacific -- could prove more difficult, he said. 
 
 The rubella vaccine, 95 percent effective at preventing infection, was first licensed in 1969. 
 
 Pan American Health Organization member countries in 1994 set goals of eliminating measles from the Americas by 2000, and rubella and congenital rubella syndrome by 2010. The measles goal was achieved two years behind the target date, in 2002. Rubella and congenital rubella syndrome were wiped out on schedule, although the official announcement was not made until this year to ensure that the disease had indeed been eradicated. 
 
 The U.S. has backslid on its measles eradication in recent months. A measles outbreak originating this year from California's Disneyland infected 117 people. The outbreak triggered a national debate about mandatory childhood vaccines. 
 

– Goodbye and good riddance to rubella, which has joined smallpox and polio in being completely eradicated from the Americas. The disease, also known as German measles, has devastating consequences for unborn children, including blindness, deafness, and heart defects, when pregnant women catch it in the first trimester. In a big US outbreak in 1964 and 1965, 11,000 fetuses died and 20,000 children suffered serious birth defects, the New York Times reports. The last endemic cases reported in the Americas were in Argentina and Brazil in 2009 and health chiefs now say that in a "historic achievement," the Americas are the first region in the world that can be declared free of the virus, reports the BBC. "Although it has taken some 15 years, the fight against rubella has paid off," the director of the Pan American Health Organization tells the Times. "Now, with rubella under our belt, we need to roll up our sleeves and finish the job of eliminating measles as well." She says the eradication shows "how important it is to make vaccines available even to the remotest corners of our hemisphere." Health authorities aim to make Europe the next rubella-free region by the end of this year, and hope to make the disease extinct worldwide by 2020, the Huffington Post reports. (Smallpox is the only infectious human disease to have been completely wiped out, but the deadly cattle virus rinderpest was eradicated in 2010.)