Rubella in Poland in 2016

INTRODUCTION: Rubella is the disease subject to the elimination programme coordinated by the World Health Organization (WHO). Generally, rubella is an infection of mild course among children but in the case of pregnant women, who are not immunized, the probability of the occurrence of severe congenital abnormalities (congenital rubella syndrome) may amount to 95%. The strategy of the countries belonging to the WHO European Region is directed to the interruption of the rubella virus transmission in the environment in order to prevent the cases of congenital rubella syndrome (CRS). OBJECTIVES: OBJECTIVES. The aims of the present article are to analyze the epidemiological situation of rubella in Poland in 2016 and to discuss the rubella vaccination coverage. MATERIAL AND METHODS: The epidemiological situation of rubella in Poland was analyzed on the basis of publications: "Infectious diseases and poisonings in Poland in 2016" and "Vaccinations in Poland in 2016". RESULTS: In 2016, there was a decrease in the number of rubella cases - with registered 1 105 cases (in 2015 ­ 2 027 cases) - and a decline in incidence (from 5.3 per 100 000 to 2,9). The highest incidence rate, regardless of gender and the environment, was observed among children aged 0-4 years (27.9 per 100,000). The incidence of rubella in boys and men was identical 2.9. In 2016, no cases of congenital rubella syndrome were registered. SUMMARY AND CONCLUSIONS: In 2016, there was a decrease in the number of rubella cases. In Poland Rubella is reported exclusively on the basis of the clinical picture. The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland.

Reducing global disease burden of measles and rubella: report of the WHO Steering Committee on research related to measles and rubella vaccines and vaccination, 2005.

The WHO Steering Committee reviewed and evaluated the progress towards global control of measles and rubella and provided guidelines for future research activities concerning both diseases during its meeting in New Delhi, in April 2005. Global measles vaccination coverage increased from 71% in 1999 to 76% in 2004 and indigenous transmission was interrupted or kept at very low levels in many countries. However, Africa and Southeast Asia continue to experience endemic transmission and high mortality rates, despite a global mortality reduction of 39% between 1999 and 2003. On the basis of reports from countries with continued indigenous measles virus transmission, future control strategies as well as advantages and potential drawbacks of global measles eradication were discussed. Similarly the burden of rubella and congenital rubella syndrome (CRS) as well as the cost-effectiveness of rubella vaccination was assessed using different methods in several countries without vaccination programs. As measles and rubella viruses continue to circulate surveillance and control strategies need further optimization. RT-PCR was considered as an alternative method for laboratory diagnosis of CRS. The value of dried blood spots and oral fluid as alternative samples for measles and rubella IgG and IgM detection and genotype determination was evaluated. However further validation of these methods in different settings is required before their routine use can be recommended.

Cost-benefit analysis of routine mumps and rubella vaccination for Israeli infants.

Until January 1989, mumps vaccine was not routinely administered in Israel, and rubella immunization was restricted to adolescent girls. The theoretical effect of combined mumps-rubella vaccination was applied to a population consisting of a cohort of 1-year-old children followed for 13 years. Assuming 90% compliance and 95% vaccine efficacy, projected clinical cases of mumps, rubella, encephalitis and thrombocytopenia would be reduced by 4,144; 3,109; 13; and 1 respectively. We anticipate a benefit to cost ratio of between 1.17 and 1.77 for the program. Since only 10-20% of cases are reported, the true benefit to cost ratio is likely to be at least 5.85. The benefit to cost ratio based on health service benefits alone is between 0.34 and 0.52; however, after adjusting for under-reporting, benefits are expected to exceed costs. Expenditures for laboratory testing, a factor not previously considered in such an analysis, would be reduced by approximately $2,750 per year. These results justify the initiation in January 1989 of nationwide routine vaccination.

The decline in congenital rubella syndrome in Western Australia: an impact of the school girl vaccination program?

Rubella vaccination became available in 1970 in Australia. In Western Australia (WA), a school girl vaccination program was well established by 1971. Mothers under 26 years of age in 1983 would have been eligible for this program and they constitute 40 per cent of WA births. Data on Congenital Rubella Syndrome (CRS) cases were obtained for years of birth 1968-83 inclusive to ascertain if there had been an impact of the program on the CRS rate. Epidemics of rubella occurred in 1970-71, 1974, and 1979-80. The CRS rate has fallen steadily; it did not rise during the 1979-80 epidemic and was less than one in each year after 1977. All CRS cases born since 1974 were to mothers too old to have been eligible for the program. The data suggest that the vaccination program is effective, but this cannot be proven until data become available on pregnancy terminations.

[Retrospective study on the mortality of children under 5 in a rural district of the region of Brazzaville (People's Republic of Congo). I. Rate and causes of mortality]. / Etude rétrospective sur la mortalité de l'enfant de moins de 5 ans dans une zone rurale de la région de Brazzaville (R. P. Congo). I. Taux et causes de mortalité.

A retrospective study of 1,003 children permits us to identify precisely rates and causes of mortality in children under 5 years old in a rural holoendemic malaria area of the People's Republic of the Congo. The mortality rates are distinctly lower than those generally observed in tropical Africa. Infant mortality (0-1 year) was found to be 71%, mortality 13%, early neonatal mortality (0-7 days) 41% and mortality between 1-5 years, 49%. Main causes of mortality are those related to pregnancy (prematurity, obstetrical pathology) and with infectious diseases particularly measles. On the other hand, no death seems to be attributable directly to malaria in this study.