title: Rubella outbreaks following virus importations: the experience of Chile.
abstract: BACKGROUND
  Strategies for accelerated control of rubella and congenital rubella syndrome (CRS) in Chile included mass vaccination of women of childbearing age in 1999 but did not include vaccination of adult men.
  
  
  METHODS
  We reviewed data from Chile's integrated surveillance system for measles, rubella, and CRS from 2004 through 2009 and describe the epidemiology of rubella outbreaks and implementation of control measures in 2005 and 2007 following mass vaccination of women. Population estimates from census data were used to calculate rubella incidence rates. The age distribution of rubella cases during 2007 was compared with rubella vaccination opportunities by birth cohort to orient mass vaccination of adult men.
  
  
  RESULTS
  In 2005, an institutional outbreak of rubella occurred among male naval recruits 18-22 years of age, with 46 confirmed cases over a 5-month period. Beginning in March 2007, rubella outbreaks among young adults in the capital of Santiago spread throughout Chile, resulting in >4000 confirmed rubella cases. Delayed control measures and rapid dissemination among young adults led to widespread transmission. From 2007 through 2009, rubella incidence was highest among adult men not included in previous vaccination strategies. Mass vaccination of men 19-29 years of age was conducted in November 2007 to interrupt rubella transmission.
  
  
  CONCLUSIONS
  Chile's experience suggests that vaccination strategies for rubella and CRS elimination need to include both men and women.
authors.affiliation: Department of Epidemiology, Ministry of Health, Santiago, Chile. dgallego@minsal.cl
authors.forename: Doris
authors.initials: D
authors.lastname: Gallegos
authors.forename: Andrea
authors.initials: A
authors.lastname: Olea
authors.forename: Viviana
authors.initials: V
authors.lastname: Sotomayor
authors.forename: Claudia
authors.initials: C
authors.lastname: González
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Muñoz
authors.forename: Mónica
authors.initials: M
authors.lastname: Ramos
authors.forename: M Cecilia
authors.initials: MC
authors.lastname: Espinoza
authors.forename: Gladys
authors.initials: G
authors.lastname: Mendoza
authors.forename: Graciela
authors.initials: G
authors.lastname: Torres
authors.forename: Emilio
authors.initials: E
authors.lastname: Espiñeira
authors.forename: Winston
authors.initials: W
authors.lastname: Andrade
authors.forename: Jorge
authors.initials: J
authors.lastname: Fernández
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Fasce
mesh_terms: D000293:Adolescent; D000328:Adult; D002677:Chile / Q000453:epidemiology; D003140:Communicable Disease Control / Q000266:history / Q000379:methods; D004196:Disease Outbreaks / Q000517:prevention & control*; D054242:Emigrants and Immigrants; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D032541:Mass Vaccination; D008889:Military Personnel; D012409:Rubella / Q000453:epidemiology* / Q000517:prevention & control*; D012411:Rubella Vaccine / Q000276:immunology*; D014195:Travel; D055815:Young Adult
chemical_list: D012411:Rubella Vaccine