Characterizing the dynamics of rubella relative to measles: the role of stochasticity

Abstract

Rubella is a completely immunizing and mild infection in children. Understanding its behaviour is of considerable public health importance because of congenital rubella syndrome, which results from infection with rubella during early pregnancy and may entail a variety of birth defects. The recurrent dynamics of rubella are relatively poorly resolved, and appear to show considerable diversity globally. Here, we investigate the behaviour of a stochastic seasonally forced susceptible–infected–recovered model to characterize the determinants of these dynamics and illustrate patterns by comparison with measles. We perform a systematic analysis of spectra of stochastic fluctuations around stable attractors of the corresponding deterministic model and compare them with spectra from full stochastic simulations in large populations. This approach allows us to quantify the effects of demographic stochasticity and to give a coherent picture of measles and rubella dynamics, explaining essential differences in the recurrent patterns exhibited by these diseases. We discuss the implications of our findings in the context of vaccination and changing birth rates as well as the persistence of these two childhood infections.

Impact of Population Size on Incidence of Rubella and Measles in Comparison with That of Other Infectious Diseases

“…Osaka, which is one of the most populated prefectures in Japan, had an incidence of measles of 4 cases per 8,865,000 population (0.45/million) in 2012 (3). I entirely agree with Rozhnova et al (22) in that``for rubella, reducing R 0 by vaccinating or declining birth rate unambiguously results in higher extinction probabilities. ''…”

Persistent Chaos of Measles Epidemics in the Prevaccination United States Caused by a Small Change in Seasonal Transmission Patterns

“…The relative importance of noise and determinism in population dynamics varies with context: for instance, stochasticity appears to generate proportionally more of the amplitude in rubella cycles (as well as driving patterns in local extinction), because the deterministic skeleton of these dynamics falls on an attractor that is globally less stable [ 41 ]. Similarly, the intermittent 3–4 year periodic pertussis dynamics is thought to emerge from stochastic resonance around a deterministic skeleton with a dominant annual period [ 42 ].…”

Rubella Seroprevalence among the General Population in Dongguan, China

“…However, infection with rubella virus in the first trimester of pregnancy may lead to miscarriage, stillbirth or a child born with congenital rubella syndrome (CRS). CRS is one of the greatest risks to newborn infants and may entail a variety of birth defects, such as sensor-ineural deafness, cataracts, and cardiac defects (1,2). Therefore, in 2000, the World Health Organization (WHO) recommended the use of the rubella-containing vaccine (RCV) in all national childhood immunization schedules to prevent congenital rubella infection, including CRS (3).…”