dr. anthony fauci and jenna tobias. good morning. caller: good morning. t0 years ago, i worked a something that was known as a rubella project in new york city under dr. lewis cooper. i wondered, what is the status of rubella now, with vaccines for mothers and children? host: thank you. guest: we have an excellent rubella vaccine now, developed in the 1960's. we had a problem back then where babies get infected, children get infected with rubella, it's a relatively mild disease. rubella becomes a real problem when women of childbearing age get pregnant and get infected with rubella during pregnancy. then you get the congenital rubella syndrome. we had about 20,000 cases of congenital rubella syndrome in the 1960's, until an effective vaccine came through, and all of us have gotten vaccinated against rubella. right now the congenital rubella syndrome has essentially disappeared, because people get vaccinated, and when women get pregnant, they don't get rubella because they were vaccinated when they were a child. it's really a success story with the rubella

dr. anthony fauci is the dr. infectious diseases and the author of the book americans at risk.re not prepared for disasters and what we can do. dr. sanjay. >> outbreak is usually when you see some sort of eruption of an infection you wouldn't otherwise expect to see. epidemic is when something starts to spread rapidly among the population. pandemic is when it's spreading around the world. endemic is when it becomes intrenched in a particular place. so certain malaria would be an example. something that started in these first stages but now endemic within certain parts of africa. >> in terms of risk, you say you can't prevent outbreaks, you can't prevent the emergence of a new infectious agent but you can prevent how it spreads. >> exactly. and that's the whole point. microbes emerge and reemerge. the critical issue is to prevent an outbreak from becometic an epidemic and then a pandemic. with vaccine development, you can blunt that spread. so people think prevent an outbreak. you're just not going to do that. there will be emergence of -- for example when we had ebola in africa

dr. anthony though fauci. what have you learned in working on this?uest: this is an extraordinary demonstration of the kinds of challenges you have of emerging and r