Surveillance of congenital rubella and rubella infections in pregnancy in EU/EEA countries, 2012: Current status and future perspective to monitor elimination |
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| Institution: | 1. Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;2. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden;3. Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden;1. College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China;2. Co-Innovation Center of Jiangsu for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu 225009, China;3. Center for Infectious Diseases and Vaccinology, The Biodesign Institute and School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401, USA;4. Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32611-0880, USA;1. Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster, OH, United States;2. Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States;3. Division of Infectious Diseases, Cincinnati Children''s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States;4. Poultry Diseases Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt;1. Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands;2. National Primary Care Research Group (NPCRG), University of Manchester, United Kingdom;1. Department of Psychiatry, Eulji Addiction Institute, Gangnam Eulji Hospital, Eulji University, Seoul, South Korea;2. Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea;3. Department of Psychiatry, The Armed Forces Capital Hospital, Seongnam, Gyeonggi, South Korea;4. Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea;5. Sleep Health Center, Severance Hospital, Seoul, South Korea;6. Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Gyeonggi, South Korea;7. Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea;8. Department of Internal Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea;1. Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), United States;2. National Center for Immunizations and Respiratory Diseases, CDC, United States;3. Emory University, Rollins School of Public Health, Biostatistics and Bioinfomatics, United States |
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| Abstract: | IntroductionRubella elimination and congenital rubella syndrome (CRS) prevention are targets for achievement by 2015 in the WHO-EURO Region. This paper describes the existing surveillance systems for CRS and rubella in pregnancy in order to critically interpret the findings in relation to the 2012 WHO-EURO surveillance guidelines.MethodsIn 2012 we conducted a survey to collect information on surveillance of CRS and rubella in pregnancy in 29 EU/EEA countries. Questionnaires explored the characteristics of the surveillance systems, case definition, epidemiological investigation and follow-up of cases, reference laboratories and types of tests performed.ResultsTwenty-eight countries had surveillance systems for CRS, mostly nationwide, mandatory, passive and case-based; 23 collected information on the origin of the infection; 11 reported asymptomatic infections; 6 required zero-reporting. Case definitions varied among countries, although 24 used the EU definition. Laboratories reported cases in 18 countries. Twenty countries collected information on pregnancy within the rubella surveillance system and 5 had specific surveillance for rubella in pregnancy. Two countries did not monitor outcomes of suspected infections in pregnancy; infants with CRS were monitored in all the remaining countries; asymptomatic infected infants in 15; stillbirths and fetal deaths in 13; therapeutic and spontaneous abortions in 8 and 7. Twenty-seven countries had a national reference laboratory for CRS and rubella in pregnancy; genotyping was performed in 15.DiscussionThe current surveillance systems allow adequate CRS monitoring in EU. Further efforts are needed to improve their quality, including uniform case definitions, collection of information on the origin of infection, and promotion of reporting from laboratories. Follow-up of pregnant women with suspected infection should be strengthened because it is an entry point for CRS, including detection of fetal deaths, stillbirths and abortions. Laboratory capacity for confirming congenital rubella infections and infections in pregnancy is good in EU, however the use of genotyping should be encouraged. |
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| Keywords: | Congenital rubella Pregnancy Surveillance Monitoring Elimination Europe |
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