Adequacy of Surveillance to Detect Endemic Rubella Transmission in the United States
Open Access
- 1 November 2006
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 43 (Supplement), S151-S157
- https://doi.org/10.1086/505948
Abstract
Background.Reported rubella cases in the United States are at the lowest numbers since the introduction of vaccine, suggesting that endemic transmission may have been interrupted. It is necessary to validate that the observed absence of rubella is due to the disappearance of disease rather than a failure of rubella surveillance. Methods.Adequate rubella surveillance to detect ongoing transmission is characterized by evidence that rubella investigations are being conducted, detection of importations, and lack of spread from confirmed cases. We reviewed rubella surveillance data and activities from 5 sources: (1) data reported to the national surveillance system; (2) a survey of health departments and public health laboratories, including questions regarding any links between measles and rubella surveillance; (3) enhanced rubella surveillance activities in California and in New York City; (4) sentinel surveillance along the US-Mexico border; and (5) case detection in 8 large health maintenance organizations (HMOs). Results.During 2002–2004, 35 cases of rubella were reported to the national system, including 12 (34%) imported cases. The 39 programs that responded to our survey reported conducting 1482 investigations for rubella; according to another national survey, 1921 investigations were conducted for measles. Forty-one laboratories responded to our survey and reported conducting 6428 tests for acute rubella. No previously undetected (or unreported) cases of rubella or congenital rubella syndrome were identified by our survey or reviews of surveillance in California, New York, and along the US-Mexico border, and no additional cases were detected in the HMO database. Conclusions.No previously unrecognized spread cases or outbreaks of rubella were detected. Surveillance in the United States is sufficiently sensitive to identify indigenous cases of rubella, if they were occurring, supporting the contention that rubella has been eliminated from the United States.Keywords
This publication has 8 references indexed in Scilit:
- The Epidemiological Profile of Rubella and Congenital Rubella Syndrome in the United States, 1998–2004: The Evidence for Absence of Endemic TransmissionClinical Infectious Diseases, 2006
- Measles surveillance: the importance of finding the tip of the icebergThe Lancet, 2005
- Summary and Conclusions: Measles Elimination Meeting, 16–17 March 2000The Journal of Infectious Diseases, 2004
- Lessons Learned from Establishing and Evaluating Indicators of the Quality of Measles Surveillance in the United States, 1996–1998The Journal of Infectious Diseases, 2004
- Has Surveillance Been Adequate to Detect Endemic Measles in the United States?The Journal of Infectious Diseases, 2004
- The U.S.-Mexico Border Infectious Disease Surveillance Project: Establishing Binational Border SurveillanceEmerging Infectious Diseases, 2003
- The Changing Epidemiology of Rubella in the 1990sJAMA, 2002
- Mandatory Reporting of Diseases and Conditions by Health Care Professionals and LaboratoriesJama-Journal Of The American Medical Association, 1999