title: An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013.
abstract: BACKGROUND
  During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented.
  
  
  METHODS
  Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS.
  
  
  RESULTS
  A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy.
  
  
  CONCLUSIONS
  Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases.
authors.affiliation: WHO Headquarters, Geneva, Switzerland .
authors.forename: Kara N
authors.initials: KN
authors.lastname: Durski
authors.affiliation: National Referral Hospital, Honiara, Solomon Islands .
authors.forename: Carol
authors.initials: C
authors.lastname: Tituli
authors.affiliation: Ministry of Health and Medical Services, Honiara, Solomon Islands .
authors.forename: Divi
authors.initials: D
authors.lastname: Ogaoga
authors.affiliation: Office of the WHO Representative in Solomon Islands, Honiara, Solomon Islands .
authors.forename: Jennie
authors.initials: J
authors.lastname: Musto
authors.affiliation: Ministry of Health and Medical Services, Honiara, Solomon Islands .
authors.forename: Cynthia
authors.initials: C
authors.lastname: Joshua
authors.affiliation: National Referral Hospital, Honiara, Solomon Islands .
authors.forename: Alfred
authors.initials: A
authors.lastname: Dofai
authors.affiliation: Victorian Infectious Diseases Reference Laboratory (VIDRL), The Doherty Institute, Melbourne, Victoria, Australia .
authors.forename: Jennie
authors.initials: J
authors.lastname: Leydon
authors.affiliation: Division of Pacific Technical Support, WHO, Suva, Fiji .
authors.forename: Eric
authors.initials: E
authors.lastname: Nilles
mesh_terms: D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008542:Melanesia / Q000453:epidemiology; D011159:Population Surveillance; D011446:Prospective Studies; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology*