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Epidemiologic Reviews Advance Access published online on June 14, 2006
Epidemiologic Reviews, doi:10.1093/epirev/mxj007
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Epidemiologic Reviews Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Accepted April 4, 2006

Article

Prevention of Congenital Rubella Syndrome--What Makes Sense in 2006?

Joan L. Robinson 1 *, Bonita E. Lee 1, Jutta K. Preiksaitis 1, Sabrina Plitt 2, and Graham A. Tipples 3

1 Provincial Laboratory for Public Health (Microbiology), Edmonton, Alberta, Canada
2 Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
3 National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada

* To whom correspondence should be addressed.
Joan L. Robinson, E-mail: jr3{at}ualberta.ca


  Abstract

This review summarizes the practical aspects of rubella immunization programs in both developed and developing countries. Routine use of rubella vaccine is gradually resulting in the elimination of endemic rubella and congenital rubella syndrome (CRS) in the developed world, and routine use of vaccine in young children is now being implemented in many developing countries. However, such programs must achieve high immunization rates or be supplemented by the immunization of seronegative women of childbearing age to prevent a paradoxical increase in CRS as the burden of illness is shifted to an older age group. There are many successful prenatal screening programs for rubella immunity in developed countries, but screening prior to pregnancy could theoretically prevent even more cases of CRS. Enzyme-linked immunosorbent assay is the most commonly used laboratory test for screening, but the protective titer remains to be established. The need for reimmunization of women who serorevert or who remain seronegative following rubella vaccine has not been established. Surveillance for rubella cases and for CRS is vital in assessment of the ongoing success of rubella immunization programs.

Keywords: antibodies, viral; immunization programs; rubella; rubella syndrome, congenital; rubella vaccine; rubella virus.
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