title: Surveillance for congenital rubella in Australia since 1993: cases reported between 2004 and 2013.
abstract: OBJECTIVE
  To describe the epidemiology of congenital rubella infections notified to the Australian Paediatric Surveillance Unit (APSU) from 2004 to 2013 and compare that with previously published APSU data for 1993-2003.
  
  
  METHODS
  Active national surveillance for congenital rubella infection has been conducted through the APSU since 1993. Monthly reporting by child health clinicians according to pre-defined case criteria triggers requests for clinicians to provide de-identified clinical, epidemiological, and laboratory information. Data were extracted for cases reported between January 2004 and December 2013 and compared with previous years.
  
  
  RESULTS
  Five cases of confirmed congenital rubella infection were identified during the reporting period. All five infants had defects consistent with congenital rubella syndrome (CRS). Four of the infants were born in Australia during the study period, and all were born to mothers born overseas. Three of the five mothers had not had rubella vaccination, and in two vaccination status was unknown, although both were from countries without routine rubella immunization programmes. Since 1993, there have been 57 notifications of congenital rubella infection to the APSU; 40 of these infants were born between January 1993 and December 2013, of whom 34 had confirmed CRS.
  
  
  CONCLUSIONS
  Congenital rubella infection in Australia is predominantly among children born to unimmunized immigrant mothers. Migrant women born in rubella endemic countries without routine immunization remain an important group to target for vaccination. Rubella-susceptible women, especially those in the early stages of pregnancy, should also carefully consider the risks of travelling to rubella endemic countries.
authors.affiliation: Centre for Perinatal Infection Research, The Children's Hospital at Westmead, NSW, Australia; National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, NSW, Australia.
authors.forename: Gulam
authors.initials: G
authors.lastname: Khandaker
authors.affiliation: Sydney Medical School, The University of Sydney, NSW, Australia; Australian Paediatric Surveillance Unit, Sydney, NSW, Australia.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Zurynski
authors.affiliation: Centre for Perinatal Infection Research, The Children's Hospital at Westmead, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia; Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, NSW, Australia; The Children's Hospital at Westmead, NSW, Australia. Electronic address: cheryl.jones@health.nsw.gov.au.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012409:Rubella / Q000151:congenital*; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology*; D055815:Young Adult
keywords: Congenital rubella syndrome; Rubella; Vaccination