title: New features of rubella in Spain: the evidence of an outbreak.
abstract: In most of western Europe the rubella vaccine coverage is high. However, prior to the introduction of the vaccine in Latin America, rubella susceptibility in women of childbearing age was 10-25%. Forty one (93%) countries in Latin America have adopted the rubella vaccine since 2002. The adult immigrant population in Spain constitutes a group of susceptibles. In February 2003, the Madrid Community Measles Elimination Plan detected an increase in rubella notifications in women who had been born in Latin America. A descriptive study was undertaken to characterise the outbreak. A confirmed case was a person with fever or rash and a positive IgM serology, and living in Madrid, between 1 December 2002 and 31 March 2003. The secondary attack rate (SAR) per household was calculated. A total of 19 cases of rubella were identified, 15 were confirmed and 4 were probable cases. Fourteen (73.7%) cases were women at childbearing age. The mean age was 25.1 years. One pregnancy was diagnosed with a voluntary termination. Eleven (57.9%) cases were from Ecuador. The mean time of residence in Spain was 41 months. None of the cases or the 54 (78.3%) household contacts had been vaccinated against rubella. The SAR was 9.1%. This study showed the spread of rubella in the susceptible Latin American Community that is resident in Madrid. The interventions proposed were a vaccination programme towards immigrants, a health education campaign to prevent congenital rubella, and a health professional training programme case management.
authors.affiliation: European Programme for Intervention Epidemiology Training, Instituto de Salud Carlos III, Centro Nacional de Epidemiología, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Lemos
authors.forename: R
authors.initials: R
authors.lastname: Ramirez
authors.forename: M
authors.initials: M
authors.lastname: Ordobas
authors.forename: D H
authors.initials: DH
authors.lastname: Guibert
authors.forename: J C
authors.initials: JC
authors.lastname: Sanz
authors.forename: L
authors.initials: L
authors.lastname: Garcia
authors.forename: J F
authors.initials: JF
authors.lastname: Martinez Navarro
mesh_terms: D000293:Adolescent; D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008875:Middle Aged; D012409:Rubella / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology