Published: 06.10.05 Updated: 07.10.2005 09:20:31
Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region
Rubella is a notifiable disease in all the countries in the region with exception of Germany, where only congenital rubella syndrome is notified. Germany is the only country in the region that has introduced specific surveillance of congenital rubella syndrome (CRS). In the other countries, congenital cases are normally identified through the rubella surveillance systems.
In the western part of the region measles-mumps-rubella (MMR) vaccine was introduced as a part of national immunisation programmes in the early 1980s. Thanks to high immunisation 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, where vaccination was introduced in the early 1990s. Low immunisation coverage, especially in Northwest Russia, has resulted in outbreaks of rubella and subsequent fear of increasing number of children born with congenital rubella syndrome.
Although most cases of rubella in the region occurs among children, non-immune women of childbearing age are the main targeted group for rubella prevention and can as such be regarded as a high-risk group.
Vaccination with a rubella mono-vaccine or as a part of the MMR-vaccine, is the best measure to decrease the incidence rate of rubella and henceforth to prevent CRS. Rubella vaccine is a part of the national immunisation programme in all the countries in the region. Except for Russia, all countries in the region now use the MMR-vaccine. In Northwest Russia immunisation programmes with a separate rubella vaccine have not been fully implemented due to lack of funding for vaccines.