Rubella and congenital rubella syndrome control and elimination - global progress, 2000-2012

Abstract

Rubella virus usually causes a mild fever and rash in children and adults. However, infection during pregnancy, especially during the first trimester, can result in miscarriage, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy for introduction of rubella-containing vaccine (RCV) into national routine immunization schedules with an initial wide-age-range vaccination campaign that includes children aged 9 months-15 years. WHO also urged all member states to take the opportunity offered by accelerated measles control and elimination activities as a platform to introduce RCVs. The Global Measles and Rubella Strategic Plan (2012-2020) published by the Measles Rubella Initiative partners in 2012 and the Global Vaccine Action Plan endorsed by the World Health Assembly in 2012 include milestones to eliminate rubella and CRS in two WHO regions by 2015, and eliminate rubella in five WHO regions by 2020. This report summarizes the global progress of rubella and CRS control and elimination during 2000-2012. As of December 2012, a total of 132 (68%) WHO member states had introduced RCV, a 33% increase from 99 member states in 2000. A total of 94,030 rubella cases were reported to WHO in 2012 from 174 member states, an 86% decrease from the 670,894 cases reported in 2000 from 102 member states. The WHO Region of the Americas (AMR) and European Region (EUR) have established rubella elimination goals of 2010 and 2015, respectively. AMR has started to document the elimination of measles, rubella, and CRS; in EUR, rubella incidence has decreased significantly, although outbreaks continue to occur.

FIGURE 1

Proportion of surviving infants receiving rubella-containing vaccine (RCV) — World Health Organization (WHO) regions, 2000–2012^{* *} Based on WHO–United Nations Children’s Fund (UNICEF) estimates of rubella coverage. Note: China introduced RCV into its immunization schedule in 2008.

FIGURE 2

World Health Organization member states that have introduced rubella-containing vaccine (RCV) and member states potential to introduce RCV with GAVI Alliance support,^* 2012 ^* Additional information about the GAVI Alliance, formerly the Global Alliance for Vaccines and Immunisation, and the support it provides, is available at http://www.gavialliance.org.