Comparison of rubella seroepidemiology in 17 countries: progress towards international disease control targets

Seroprevalence of antibodies against measles, rubella, mumps, varicella-zoster, andB. Pertussisin young adults of Madrid, Spain

“…22 The seropositivity values found for the cohort of women born after 1986 agree with this supposition.…”

Could the United States experience rubella outbreaks as a result of vaccine refusal and disease importation?

“…64 Additionally, a study of rubella seroepidemiology in Australia and 16 European countries from 1996 to 2004 found that over 10% of children ages 2 to 14 were seronegative for rubella in four countries (Belgium, Ireland, England and Wales, and Bulgaria). 65 In 11 of the European countries studied, more than 5% of women of childbearing age lacked protective immunity against rubella. 65 As a result of insufficient immunization, rubella continues to circulate and to cause outbreaks around the world.…”

Is the current prevention strategy based on vaccination coverage and epidemiological surveillance sufficient to achieve measles and rubella elimination in Europe?

“…During the 2003-2013 period, the number of rubella cases was >6000 only in 2012 due to a large outbreak of 20,772 cases in Poland, but rubella cases were reduced to 778 in 2013 [3]. Results obtained in the serological survey carried out in Spain in 2003 showed that herd immunity against rubella was established in all age groups [5], and the ESEN project found a prevalence of susceptible children >10% only in four countries [11].…”

“…The ESEN project [11] evaluated the risk of rubella outbreaks in Europe in 2001-2003, classifying European countries based on the prevalence of seronegative children aged 2-14 years in three groups: group I for <5% seronegative, group II for 5-10% seronegative and group III for >10% seronegative. The study found that four countries in group I, seven countries in group II and four countries in group III [11]. The ESEN project standardized serological results from different ELISA tests, but a consistent analysis of the risk of measles and rubella outbreaks requires to assess herd immunity levels in representative samples of the population.…”

“…Spain had a low risk for measles outbreaks in the ESEN study [10], but multiple outbreaks have occurred since 2003 [3,4]. The ESEN project [11] evaluated the risk of rubella outbreaks in Europe in 2001-2003, classifying European countries based on the prevalence of seronegative children aged 2-14 years in three groups: group I for <5% seronegative, group II for 5-10% seronegative and group III for >10% seronegative. The study found that four countries in group I, seven countries in group II and four countries in group III [11].…”