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Global rubella elimination lags behind WHO goals
While cases of rubella have declined dramatically worldwide since 2000, reported elimination and control in 2014 lags behind WHO goals to eliminate rubella and congenital rubella syndrome in two regions before year’s end and in five regions by 2020, according to MMWR.
“Recent and future rubella-containing vaccine introductions provide an opportunity and motivation to establish and achieve regional rubella and congenital rubella syndrome elimination goals,” Gavin B. Grant, MD, of the CDC’s global immunization division, and colleagues wrote. “However, key challenges to achieving rubella elimination goals include civil unrest (Eastern Mediterranean Region), weak health care delivery systems with low routine vaccination coverage (African and South-East Asia Region), and vaccination hesitancy (European Region).”
The investigators found that worldwide rubella cases have declined 95%, from 670,894 cases worldwide in 2000, to 33,068 cases in 2014. The investigators also monitored the introduction of rubella-containing vaccine worldwide, which has been introduced in 72% of the countries monitored.
These gains, however, still fall short of WHO’s plan to eradicate rubella in two regions this year and in five regions by 2020. As of 2014, the Americas are the only region to have reported zero cases of congenital rubella syndrome (CRS). Other regions targeted for control and elimination of CRS include Europe, which reported 27 cases in 2014 vs. 47 in 2000; while South-East Asia and the Western Pacific experienced increased cases of CRS.
Eradication and control efforts for general rubella also are insufficient to meet WHO goals. The Americas region, which has reduced the number of reported cases, from 39,228 in 2000 to four cases in 2014, and the European region (621,039 vs. 640 cases) are the only regions that appear ready to eliminate rubella by year’s end. Meanwhile, the Africa, South-East Asia and Western Pacific regions have reported increases in rubella incidence between 2000 and 2014.
From 2000 to 2014, the number of African countries reporting CRS increased from 3 to 17, and an increase also was observed in the Americas, from 18 to 35 countries.
“To achieve rubella elimination and control goals, a strong commitment is required at national and subnational levels in all countries to introduce rubella-containing vaccine, achieve high rubella vaccine coverage in routine immunization services, and conduct high-quality rubella and congenital rubella syndrome surveillance,” Grant and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
