The Opportunity and Obligation to Eliminate Rubella From the United States

Orenstein, Walter A.

doi:10.1001/jama.1984.03340390042027

Cited by 97 publications

(7 citation statements)

References 20 publications

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“…The model yields estimates of rubella cases that correspond to approximately 24,000 pregnancy outcomes adversely affected (e.g., pregnancy terminations due to rubella, fetal deaths, infant mortality, and CRS cases) due to the maternal rubella infection associated with the large outbreak that peaked in 1964, similar to prior estimates. (56) Fig. 3 includes the model and reported data back to 1963 to show the historical fit given available historical data, and shown for 1980-2013.…”

Section: Resultsmentioning

confidence: 99%

Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases

Thompson

Badizadegan²

2017

Risk Analysis

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Policy makers responsible for managing measles and rubella immunization programs currently use a wide range of different vaccines formulations and immunization schedules. With endemic measles and rubella transmission interrupted in the region of the Americas, all five other regions of the World Health Organization (WHO) targeting the elimination of measles transmission by 2020, and increasing adoption of rubella vaccine globally, integrated dynamic disease, risk, decision, and economic models can help national, regional, and global health leaders manage measles and rubella population immunity. Despite hundreds of publications describing models for measles or rubella and decades of use of vaccines that contain both antigens (e.g., measles, mumps, and rubella vaccine or MMR), no transmission models for measles and rubella exist to support global policy analyses. We describe the development of a dynamic disease model for measles and rubella transmission, which we apply to 180 WHO member states and three other areas (Puerto Rico, Hong Kong, and Macao) representing >99.5% of the global population in 2013. The model accounts for seasonality, age-heterogeneous mixing, and the potential existence of preferentially mixing undervaccinated subpopulations, which create heterogeneity in immunization coverage that impacts transmission. Using our transmission model with the best available information about routine, supplemental, and outbreak response immunization, we characterize the complex transmission dynamics for measles and rubella historically to compare the results with available incidence and serological data. We show the results from several countries that represent diverse epidemiological situations to demonstrate the performance of the model. The model suggests relatively high measles and rubella control costs of approximately $3 billion annually for vaccination based on 2013 estimates, but still leads to approximately 17 million disability-adjusted life years lost with associated costs for treatment, home care, and productivity loss costs of approximately $4, $3, and $47 billion annually, respectively. Combined with vaccination and other financial cost estimates, our estimates imply that the eradication of measles and rubella could save at least $10 billion per year, even without considering the benefits of preventing lost productivity and potential savings from reductions in vaccination. The model should provide a useful tool for exploring the health and economic outcomes of prospective opportunities to manage measles and rubella. Improving the quality of data available to support decision making and modeling should represent a priority as countries work toward measles and rubella goals.

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Section: Resultsmentioning

confidence: 99%

Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases

Thompson

Badizadegan²

2017

Risk Analysis

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“…In this sero-survey also, we observed that the rubella immunity remains unsatisfactory, similarly like many other Indian studies. 17,18,[20][21][22][23][24][25][26] It has been a decade since many new vaccines have been introduced and given attention by the national health advisors but CRS and rubella infection still go under-recognized.…”

Section: Discussionmentioning

confidence: 99%

Sero-surveillance to assess rubella susceptibility and assessment of immunogenicity and reactogenicity of rubella vaccine in Indian girls aged 18-24 years

Phalgune

Yervadekar

Sharma

et al. 2014

Human Vaccines & Immunotherapeutics

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Rubella infection though a mild infection, may cause foetal death or a variety of congenital anomalies. Multiple sero-surveys confirmed that 5-10% women are unexposed to natural or vaccinated rubella virus and remain susceptible to rubella infection. The current study was conducted in 600 girls, aged 18-24 y from Symbiosis International University (SIU), Pune, India to assess their sero-status against rubella infection and to estimate the immunogenicity of rubella vaccine in achieving sero-protective antibody titres. Prior to administration of a single i.m. dose of rubella vaccine (R-vac®) to eligible participants, blood sample (pre-vaccination) was collected. During the 4-6 weeks observation period, adverse events were noted. Then, a second blood sample (post-vaccination) was collected. Significant increase was noted in sero-protection response, viz., 98.6% (post-vaccination) vis-à-vis 66.5% (pre-vaccination); Geometric mean titer (GMT) was significantly higher post-vaccination. Effective measures to introduce rubella vaccination on a larger scale need to be undertaken. An immunization policy with mandatory rubella vaccination for all girls in the reproductive age group and its inclusion in national immunization schedule is highly desirable.

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“…When the embryo is infected early in the first trimester it does not appear to have any conventional immunological response to prevent spread of the virus (15). Yet it has been suggested that only 1 in 10 3 to 10 5 of its cells become infected (16). …”

Section: Discussionmentioning

confidence: 99%

Congenital Blindness and Visual Impairment Cause Infection or Non Infection

Janicijevic-Petrovic

Sarenac-Vulovic²,

Janićijević³

et al. 2013

Mater Sociomed

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Conflict of interest: none declared.IntroductionAuthors are from reference documentation to archive at Organization of Federation of blind and visually impaired in central Serbia (Kragujevac), by retrograde analysis, of 2007-2012, comprehend two groups by etiology–clinical characteristics of congenital blindness and visually impaired, caused infection or non infection example.Aimto analyze relationship between infectious and non infectious of congenital blindness and visually impaired in our referent region and compare with world references.Material/methodsWith 6-years analysis included the most frequency cases of congenital blindness and visually impaired in two groups, according to presence or absence infectious causes. From infectious causes of congenital blindness and visually impaired are included: CMV – infection, congenital rubella syndrome, congenital toxoplasmosis, congenital syphilis and rare mixed syndrome. From non infectious causes are included: retinitis pigmentosa, retinopathy prematurity, primary congenital glaucoma, Leber’s congenital amaurosis and rare syndrome. Results: From total number of registered blind and visually impaired – 1308 (100%), over the last 6 years, the registration was 349 (26.68%) with congenital blindness and visually impaired. From recorder with the number of the most common congenital blindness and visually impaired–194 (55.59%) with infections cause, and 155 (44.41%) non infection cause. Conclusion: Congenital blindness has shown permanent increase in past 6 years, in group with infectious and with non infectious causes. Congenital blindness and visually impaired of the most common etiology among registered members of our association in Kragujevac is subject of our correlation and global trends mentioned observation of these diseases.

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The Opportunity and Obligation to Eliminate Rubella From the United States

Cited by 97 publications

References 20 publications

Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases

Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases

Sero-surveillance to assess rubella susceptibility and assessment of immunogenicity and reactogenicity of rubella vaccine in Indian girls aged 18-24 years

Congenital Blindness and Visual Impairment Cause Infection or Non Infection

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