title: Comparison of rubella seroepidemiology in 17 countries: progress towards international disease control targets.
abstract: OBJECTIVE
  To standardize serological surveillance to compare rubella susceptibility in Australia and 16 European countries, and measure progress towards international disease-control targets.
  
  
  METHODS
  Between 1996 and 2004, representative serum banks were established in 17 countries by collecting residual sera or community sampling. Serum banks were tested in each country and assay results were standardized. With a questionnaire, we collected information on current and past rubella vaccination programmes in each country. The percentage of seronegative (< 4 IU/ml) children (2-14 years of age) was used to evaluate rubella susceptibility, and countries were classified by seronegativity as group I (< 5%), group II (5-10%) or group III (> 10%). The proportion of women of childbearing age without rubella protection (< or = 10 IU/ml) was calculated and compared with WHO targets of < 5%.
  
  
  RESULTS
  Only Romania had no rubella immunization programme at the time of the survey; the remaining countries had a two-dose childhood schedule using the measles, mumps and rubella (MMR) vaccine. The percentage of susceptible children defined five countries as group I, seven as group II and four as group III. Women of childbearing age without rubella protection were < 5% in only five countries.
  
  
  CONCLUSIONS
  Despite the low reported incidence in many countries, strengthening the coverage of the routine two-dose of MMR vaccine among children is needed, especially in group III countries. Catch-up campaigns in older age groups and selective targeting of older females are needed in many countries to ensure necessary levels of protective immunity among women of childbearing age.
authors.affiliation: Centre for Infections, Health Protection Agency, London, England. anthony.nardone@hpa.org.uk
authors.forename: Anthony
authors.initials: A
authors.lastname: Nardone
authors.forename: Annedore
authors.initials: A
authors.lastname: Tischer
authors.forename: Nick
authors.initials: N
authors.lastname: Andrews
authors.forename: Jo
authors.initials: J
authors.lastname: Backhouse
authors.forename: Heidi
authors.initials: H
authors.lastname: Theeten
authors.forename: Nina
authors.initials: N
authors.lastname: Gatcheva
authors.forename: Marios
authors.initials: M
authors.lastname: Zarvou
authors.forename: Bohumir
authors.initials: B
authors.lastname: Kriz
authors.forename: Richard G
authors.initials: RG
authors.lastname: Pebody
authors.forename: Kalman
authors.initials: K
authors.lastname: Bartha
authors.forename: Darina
authors.initials: D
authors.lastname: O'Flanagan
authors.forename: Dani
authors.initials: D
authors.lastname: Cohen
authors.forename: Arnis
authors.initials: A
authors.lastname: Duks
authors.forename: Algirdas
authors.initials: A
authors.lastname: Griskevicius
authors.forename: Joel
authors.initials: J
authors.lastname: Mossong
authors.forename: Christopher
authors.initials: C
authors.lastname: Barbara
authors.forename: Adrianna
authors.initials: A
authors.lastname: Pistol
authors.forename: Margareta
authors.initials: M
authors.lastname: Slaciková
authors.forename: Katarina
authors.initials: K
authors.lastname: Prosenc
authors.forename: Kari
authors.initials: K
authors.lastname: Johansen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005062:European Union / Q000706:statistics & numerical data; D005260:Female; D014943:Global Health; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D038622:Internationality; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine; D008875:Middle Aged; D011159:Population Surveillance; D015397:Program Evaluation; D011634:Public Health; D012409:Rubella / Q000097:blood / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D014944:World Health Organization
chemical_list: D022542:Measles-Mumps-Rubella Vaccine