title: Progress towards measles and rubella elimination in Tuscany, Italy: the role of population seroepidemiological profile.
abstract: BACKGROUND
  As a part of the National Plan for Measles and Congenital Rubella Elimination, a catch-up campaign targeting children aged 7-14 years with Measles-Mumps-Rubella (MMR) vaccine was conducted during 2004-05 in Tuscany, Central Italy.
  
  
  METHODS
  To assess the profile of measles and rubella susceptibility, immunoglobulin G antibodies against measles (945 subjects) and rubella (1110 subjects) were detected using two commercial enzyme-linked immunosorbent assay tests in sera from a population aged 1-49 years.
  
  
  RESULTS
  Overall immunity towards measles increased in the last years, but the WHO-Euro recommended threshold of susceptibility for elimination was attained only in 2- to 4-year-olds. All fertile women up to 29 years had rates of susceptibility clearly higher than those required by WHO-Euro (5%) to eliminate congenital rubella. Despite the reduction of susceptibility among subjects targeted by the catch-up campaign, continuous efforts to increase immunization coverage are needed to eliminate measles and rubella circulation. Our results are predictive of a high chance of measles and rubella outbreaks because of the accumulation of susceptible individuals.
  
  
  CONCLUSIONS
  Additional catch-up vaccination strategies targeting the adult population (particularly fertile women) are strongly needed to eliminate the risk of measles and congenital rubella syndrome for future generations.
authors.affiliation: Department of Public Health, University of Florence, Florence, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bechini
authors.forename: Sara
authors.initials: S
authors.lastname: Boccalini
authors.forename: Emilia
authors.initials: E
authors.lastname: Tiscione
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pesavento
authors.forename: Francesco
authors.initials: F
authors.lastname: Mannelli
authors.forename: Marta
authors.initials: M
authors.lastname: Peruzzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Rapi
authors.forename: Stefano
authors.initials: S
authors.lastname: Mercurio
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006293:Health Promotion; D006801:Humans; D017589:Immunization Programs; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000627:therapeutic use; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012409:Rubella / Q000453:epidemiology / Q000517:prevention & control*; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G; D022542:Measles-Mumps-Rubella Vaccine