Published: 09.02.05 Updated: 09.02.2005 18:18:03
Rubella is a notifiable disease in the entire region. In Denmark, only laboratory confirmed congenital cases and cases in pregnant women are notified. Estonia, Lithuania, Norway and Sweden report laboratory confirmed cases, cases with typical clinical picture without laboratory confirmation and cases epidemiologically linked to a laboratory confirmed case. Northwest Russia usually reports cases with typical clinical picture without laboratory confirmation. Finland and Iceland only report laboratory confirmed cases.
In all the countries, except Denmark, congenital rubella syndrome (CRS) is normally identified through the rubella surveillance systems.
Figure 25. Number of cases of rubella notified in 2003 per 100 000 population (1).
In the western part of the region, measles-mumps-rubella (MMR) vaccine was introduced as part of national vaccination programmes in the early 1980s. Thanks to the high vaccination coverage, rubella has now become a very rare disease in all the Nordic countries. The situation is very different in the eastern part of the region. Russia and the Baltic countries did not include rubella in the schedule of mandatory, state-funded vaccines before the 1990s. Low vaccination coverage, especially in Northwest Russia, has resulted in outbreaks of rubella and subsequent risk of increasing number of children born with congenital rubella syndrome.
Vaccination, either as a separate rubella vaccine or as part of the MMR-vaccine, is the best measure to decrease the incidence rate of rubella and henceforth to prevent the congenital rubella syndrome. Rubella vaccine is part of the national vaccination programme in all the countries in the region. In Northwest Russia vaccination programmes have not been fully implemented due to lack of funding for vaccines. Vaccination coverage is very high in the Baltic and Nordic countries and is steadily improving in Northwest Russia. Rubella vaccines are also offered to young girls in the Baltic countries and Northwest Russia.