Accelerated rubella control and congenital rubella syndrome prevention strengthen measles eradication: the Costa Rican experience.
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In 2000, Costa Rica set a goal for accelerated rubella control and congenital rubella syndrome (CRS) prevention in conjunction with its established measles eradication goal. To achieve this goal, a National Plan of Action for the integration of a measles-rubella (MR) vaccination strategy was implemented. The components of the national plan included conducting a national vaccination campaign with a single dose of MR vaccine for men and women aged 15-39 years, establishing routine postpartum MR vaccination of all previously unvaccinated women, maintaining high coverage among children with two doses of measles-mumps-rubella vaccine, strengthening the integrated measles and rubella surveillance system, and developing a CRS surveillance system. This report summarizes the results of a successful adult campaign. Targeting MR vaccination appropriately and using the opportunity to strengthen surveillance for rash illness has benefits beyond accelerated rubella control and CRS prevention, including strengthening of the measles eradication program. (+info)
Immunogenicity of measles and rubella vaccines in Oman: a prospective clinical trial.
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A prospective immunogenicity trial of measles and rubella vaccines was conducted in Oman. Children received measles vaccine at age 9 months and measles-rubella vaccine at age 15 months. Serum specimens were tested for measles-specific IgG and rubella-specific IgG. Of 1025 eligible infants, 881 (86.0%) returned for all five visits and had adequate serum samples for testing. Seroconversion to measles after vaccination at 9 months was 98.1%. At 15 months, 47 (5.3%) of the 881 children were seronegative for measles; of these, 44 (93.6%) seroconverted. At 16 months, 99% of the children seronegative at age 9 months seroconverted after receiving two doses of measles vaccine. At age 15 months, 684 (77.6%) children were seronegative for rubella. Of these, 676 (98.8%) seroconverted by age 16 months. One dose of measles vaccine at age 9 months was highly immunogenic. One dose of measles-rubella vaccine at age 15 months closed the remaining measles immunogenicity gap and resulted in a high rate of rubella seroconversion. (+info)
Measles and rubella in the World Health Organization European region: diversity creates challenges.
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Since 1984, the World Health Organization (WHO) European Region has had targets for reducing the burden of a number of communicable diseases. While some countries have already met the targets for interrupting indigenous measles transmission and for reducing the incidence of congenital rubella syndrome to <1 case per 100,000 births, most have not. The cultural and economic diversity of the region present a number of challenges that must be overcome before the regional targets are met. These include social factors, political will, economic costs associated with supplementary campaigns, and more effective communication with health professionals and the public on the benefits and risks associated with immunization. Most WHO European Region member states are expected to use combined measles-mumps-rubella vaccine within the next 5 years. Consultation within the region is occurring on a strategic plan to meet the targets by 2010. (+info)
Progress toward measles elimination in Romania after a mass vaccination campaign and implementation of enhanced measles surveillance.
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In response to an outbreak of >33,000 measles cases in 1996-1998 and to prevent an outbreak predicted for 2002, Romania conducted a nationwide measles-rubella vaccination campaign in October 1998. Some 2.1 million children aged 7-18 years were vaccinated. Data from national surveillance and seroprevalence studies conducted in three districts were used to assess the campaign and status of measles control. Surveillance data showed a dramatic drop in measles despite enhanced surveillance starting in October 1999. From October 1999 to December 2001, 400 suspected measles cases were reported, down from about 5000 cases annually in non-outbreak years. Only 29 (8%) of 386 cases with specimens were laboratory confirmed; 14 were clinically confirmed. Seroprevalence estimates showed high measles antibody levels before (92.9%) and after (94.4%) the campaign. The low number of laboratory-confirmed cases and high population immunity suggest that interruption of indigenous measles virus transmission is a real possibility for Romania. (+info)
Measles-rubella mass immunization campaign in Albania, November 2000.
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In 2000, Albania resolved to eliminate measles by 2007 by use of a four-step program: by conducting a "catch-up" vaccination campaign for all children aged 1-14 years, achieving and sustaining high coverage (>/=95%) among children aged 1 year with the first dose of a measles-containing vaccine, by introducing a routine second dose of measles-containing vaccine for children at age 5 years, and by improving measles surveillance. This catch-up campaign took place in November 2000: 867,000 doses of measles-rubella vaccine were administered for an estimated coverage of 99%. In all, 231 campaign-related adverse events were reported: syncope, 206; allergic reactions, 10; fever, 8; encephalitis/encephalopathy, 2; and aseptic meningitis, seizures, Guillain-Barre syndrome, anaphylaxis, and arthralgia, 1 each. All resolved without sequelae. This report describes the status of measles and rubella/congenital rubella syndrome control in Albania before 2000 and reports on implementation of the catch-up campaign. (+info)
Investigation of a rubella outbreak in Kyrgyzstan in 2001: implications for an integrated approach to measles elimination and prevention of congenital rubella syndrome.
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In 1999, the Ministry of Health of Kyrgyzstan adopted the goal of measles elimination. This opportunity was used to launch a rubella and congenital rubella syndrome prevention program. Between January and August 2001, a rubella outbreak occurred in Bishkek City and Chui Oblast. Rubella surveillance data were reviewed for Kyrgyzstan (1981-2000) and rubella case-patient and laboratory information from Bishkek City and Chui Oblast during the outbreak. The data suggest that rubella is endemic in Kyrgyzstan with periodic epidemics every 3-5 years. From January to August 2001, 1936 rubella case-patients were reported from Bishkek City and Chui Oblast; 242 were tested and 176 (73%) were laboratory confirmed. Most case-patients were 3-14 years old. However, the incidence rate per 100,000 among persons aged 15-35 years increased >/=40-fold from 1 in 2000 to 41 in 2001. These findings highlight the importance of introducing rubella-containing vaccine in conjunction with measles elimination activities. (+info)
Phylogenetic analysis of rubella virus isolated during a period of epidemic transmission in Italy, 1991-1997.
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To study the molecular epidemiology of rubella virus during endemic transmission, phylogenetic analysis of the nucleotide sequence of the E1 gene was done with 31 isolates collected in northern Italy during 1991-1997, a period spanning 3 epidemics. The viruses segregated into distinct genotypic strains. Cocirculation of genotypic strains was detected; however, each epidemic was associated with specific strains, and strain displacement occurred concomitantly with each epidemic. Although most of the viruses from Italy belonged to rubella genotype I and many were related to viruses isolated concurrently in other European countries, 3 viruses belonged to rubella genotype II, which previously had been isolated only in Asia. Thus, intercontinental importation of viruses also occurred. (+info)
Rubella seroprevalence in Korean children.
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The aim of this study was to determine the age-specific rubella seroprevalence and the related factors in Korean children. Subjects of the study were 5393 students from 8 elementary schools in Gyeonggi Province, Korea. Questionnaire surveys with blood sampling were conducted in 1993, 1996, and 1999. ELISA tests, used to detect rubella specific IgG antibody, were Imx (R) (Abbott, U.S.A.) in 1993 and 1999, and Enzygnost (Behring, Germany) in 1996. The age-adjusted rubella susceptibility rate was 22.9% (95% CI: 22.8-23.0%) and it increased with age from 14% to 28%. The susceptibility rates of vaccinees, nonvaccinees, and the unknown group were 21%, 35%, and 27%, respectively (p=0.000). The rates by parental education levels for elementary and below, middle school, high school, and college and over were 37%, 26%, 24%, and 20%, respectively. The geometric mean titers (GMTs) of nonvaccinees, the unknown group, and vaccinees were 47 IU/mL, 42 IU/mL, and 37 IU/mL, respectively (p=0.000). The susceptibility level was too high to prevent the rubella epidemic in Korea, which necessitates a programme that will enhance the coverage for 1st and 2nd MMR vaccination among school children. In particular, more attention should be paid to the vaccination of the children whose parental education level is relatively low. (+info)