Rubella screening: organization and incentive.

Women aged 15-44 in a total population of 13,300 were screened for rubella immunity. Seventy-one per cent of the women at risk responded to a letter asking them to attend for a blood test, and of these nearly two thirds were screened. Practice expenditure on the programme was three times greater than income. We suggest a simpler, cheaper way of screening which involves minimal extra work and where an age-sex register is not required. We propose the introduction of a higher item-of-service payment for rubella vaccination.

Contraceptive cover for rubella vaccination.

PIP: Current opinion is that pregnancy should be avoided for 2-3 months after rubella vaccination because of the possible teratogenic potential of the vaccine. The possible risk of conception soon after vaccination was explained to 866 women found to be seronegative for rubella. Vaccine was administered to those sexually active only if they had used a reliable method of contraception (pill, IUD, and condom or diaphragm with spermicidal agents) for the previous month, and who consented in writing to continue for 3 more months. IUD users were also advised to use a spermicide in addition. 34% of women were on oral contraception, 14% used the condom, 5% had an IUD, 2% used the diaphragm, and 30% were not at risk of pregnancy. Counseling prior to vaccination resulted in the initiation of contraception in 7 sexually active women. Vaccination was never timed with a menstrual period.^ieng

Calcitonin for myositis ossificans.

A case of myositis ossificans, following a hemiparesis due to a cerebral haemorrhage and treated with synthetic slamon calcitonin, is described. An improvement in joint range and a cessation of further ectopic calcification was seen but, because of the remitting nature of myositis ossificans itself, the therapeutic role of calcitonin in this case is unproven.