title: Rubella in Austria 2008-2009: no longer a typical childhood disease.
abstract: BACKGROUND
  In February 2009, a cluster of rubella cases was recognized in Austria occurring between calendar weeks 3 and 7, 2009 after a long period of low rubella virus activity. A nationwide 2-dose measles, mumps, and rubella vaccination program had been introduced in 1994 to prevent this childhood illness.
  
  
  METHODS
  An epidemiologic investigation was conducted to describe the cluster by time, place, and person. A confirmed outbreak case was defined as a febrile person (1) with generalized rash, which was laboratory confirmed or epidemiologically linked to a laboratory confirmed case and (2) who became ill after October 1, 2008 in the 2 affected provinces. A probable outbreak case was defined as any person meeting the clinical criteria of rubella and meeting the criterion 2 of a confirmed outbreak case. All cases were telephone interviewed on demographics and vaccination status.
  
  
  RESULTS
  A total of 355 outbreak cases (including 247 confirmed cases) occurred in 2 neighboring Austrian provinces from mid-October 2008 until the end of June 2009, peaking in mid-March. The 2 most-affected age groups were 15 to 19 (44.4%) and 20 to 24 year olds (32.4%). The vaccination status was available for 230 cases; 10% of cases had received 1 measles, mumps, and rubella vaccine dose. No case had received 2 doses. Of the 146 female cases, one laboratory-confirmed rubella infection in a pregnant 18-year-old native Austrian resulted in elective abortion.
  
  
  CONCLUSIONS
  These findings underline the waning epidemiologic role of children in maintaining the circulation of rubella virus and indicate that additional vaccination activities targeting >15 year olds are needed to achieve the 2010 WHO target for rubella elimination in the European Region.
authors.affiliation: Austrian Agency for Health and Food Safety (AGES), Vienna, Austria. sabine.kasper@ages.at
authors.forename: Sabine
authors.initials: S
authors.lastname: Kasper
authors.forename: Franz
authors.initials: F
authors.lastname: Allerberger
authors.forename: Stephan
authors.initials: S
authors.lastname: Aberle
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Holzmann
authors.forename: Monika
authors.initials: M
authors.lastname: Redlberger
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Daghofer
authors.forename: Heidi
authors.initials: H
authors.lastname: Jakse
authors.forename: Marianne
authors.initials: M
authors.lastname: Wassermann-Neuhold
authors.forename: Odo
authors.initials: O
authors.lastname: Feenstra
authors.forename: Claudia
authors.initials: C
authors.lastname: Krischka
authors.forename: Hung-Wei
authors.initials: HW
authors.lastname: Kuo
authors.forename: Ulrich
authors.initials: U
authors.lastname: Sagel
authors.forename: Daniela
authors.initials: D
authors.lastname: Schmid
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001317:Austria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000276:immunology; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012409:Rubella / Q000453:epidemiology*; D012412:Rubella virus / Q000302:isolation & purification; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D022542:Measles-Mumps-Rubella Vaccine