An outbreak of rubella aboard a ship of the German Navy.
BACKGROUND
During May and June 1996, an outbreak of rubella occurred offshore aboard a ship of the German Navy. The outbreak spread among 330 crew members over a period of 9 weeks, ending 2 days after the ship's return. This is the first detailed epidemiological investigation of a rubella outbreak on a ship, describing temporal progression, clinical manifestations, immunization status and seroprevalence of the population exposed.


METHODS
Outbreak investigation using a questionnaire, health records and rubella serology (hemagglutination inhibition (HI) test and EIA).


RESULTS
Of the 330 crew members 298 (90%) participated in the investigation. The outbreak was continuous without a peak and ended abruptly after the ship's return. It resulted in 20 cases, 11 of which were clinically symptomatic. A total of 35 (12%) crew members were susceptible to rubella prior to the outbreak, resulting in an attack rate of 57%. The highest risk for infection was linked to accommodation aboard the ratings deck (chi(2)-test, p = 0.004) with most favorable conditions of transmission. Only 9% of the participating crew were able to provide complete proof of their immunization status. The positive predictive value of a past history of rubella for the presence of antibodies against rubella was 59%.


CONCLUSIONS
The transmission of rubella that we describe aboard a ship was facilitated by the unusually close proximity of the crew and their insufficient immunity. Documentation of immunization was inadequate in this population.
Ziebold
C
C
Department of Pediatrics, Division of Pediatric Infectious Diseases,University, Hospital Kiel, Germany.
Hassenpflug
B
B
Wegner-Bröse
H
H
Wegner
K
K
Schmitt
H J
HJ
D000914:Antibodies, Viral / Q000032:analysis; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012307:Risk Factors; D012409:Rubella / Q000453:epidemiology* / Q000517:prevention & control; D012411:Rubella Vaccine / Q000008:administration & dosage; D012412:Rubella virus / Q000276:immunology*; D012767:Ships; D014611:Vaccination / Q000639:trends
D000914:Antibodies, Viral; D012411:Rubella Vaccine