The seroepidemiology of rubella in western Europe

Most of the countries in western Europe have now implemented mass infant rubella immunization programmes, instead of or in addition to selective vaccination in order to achieve the elimination of congenital rubella syndrome.The European countries Denmark, England and Wales, Finland, France, Germany, Italy and the Netherlands undertook large, national serological surveys collecting several thousand serum specimens during 1994–8. Antibodies against rubella virus were detected by a variety of enzyme immuno-assays. Comparability of the assay results was achieved by a standardized methodology. The age- and sex-stratified serological results were related to the schedules, coverage of rubella vaccination and the incidence in these countries.The results show widely differing levels of immunity to rubella both in the general population and in the specific age groups of males and females. A low rate (< 5%) of susceptibles in childhood and adolescents of both sexes was obtained only in Finland and the Netherlands.Countries such as Italy with only moderate coverage for the infant immunization programme currently have both high susceptibility levels in the general population and in the at-risk population. The likelihood is of continued epidemics of rubella with cases of congenital rubella syndrome. The continued implementation of selective vaccination will help to offset the impact of this ongoing transmission and to protect women on reaching childbearing age.

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A model-based evaluation of the national immunization programme against rubella infection and congenital rubella syndrome in The Netherlands

Epidemiology and Infection ◽

10.1017/s0950268898001472 ◽

1998 ◽

Vol 121 (3) ◽

pp. 653-671 ◽

Cited By ~ 10

Author(s):

O. G. van der HEIJDEN ◽

M. A. E. CONYN-van SPAENDONCK ◽

A. D. PLANTINGA ◽

M. E. E. KRETZSCHMAR

Keyword(s):

The Netherlands ◽

Model Simulation ◽

Vaccination Strategy ◽

Congenital Rubella Syndrome ◽

Childbearing Age ◽

Rubella Infection ◽

Immunization Programme ◽

Congenital Rubella ◽

National Immunization Programme ◽

Notification Data

In order to improve the prevention of cases of congenital rubella syndrome in The Netherlands, in 1987 the selective vaccination strategy against rubella infection in girls was replaced by mass vaccination. This decision was supported by mathematical model analyses carried out by Van Druten and De Boo. In order to compare the predicted impact of the rubella vaccination programme with the current available data in more detail, a similar model was built. Although the model predicts elimination of the rubella virus, data show that virus circulation is still present at a higher level than expected by the model. Simulation studies indicate that import of infection and a lower vaccine effectiveness, related to possible asymptomatic reinfection of vaccinated people, could be sources contributing to the present virus circulation. Even though the number of infections is much higher than the number of reported cases of disease, limited serosurveillance data and case notification data show that females of childbearing age are well protected by immunization.

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Burden of Congenital Rubella Syndrome (CRS) in Bangladesh: Systematic Review of Existing Literature and Transmission Modelling of Seroprevalence Studies

Infectious Disorders - Drug Targets ◽

10.2174/1871526518666181004092758 ◽

2020 ◽

Vol 20 (3) ◽

pp. 284-290

Author(s):

Jocelyn Chan ◽

Yue Wu ◽

James Wood ◽

Mohammad Muhit ◽

Mohammed K. Mahmood ◽

...

Keyword(s):

Systematic Review ◽

Deterministic Model ◽

Case Series ◽

Controlled Vocabulary ◽

Congenital Rubella Syndrome ◽

Free Text ◽

Childbearing Age ◽

Vaccination Programs ◽

Congenital Rubella ◽

The Impact

Background and Objectives: Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh. Methods: We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 – 23 November 2016) and OVID EMBASE (1974 – 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh. Findings: Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero–positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh. Conclusion: The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.

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Birth desires and intentions of women diagnosed with a meningioma

Journal of Neurosurgery ◽

10.3171/2014.11.jns14522 ◽

2015 ◽

Vol 122 (5) ◽

pp. 1151-1156 ◽

Cited By ~ 5

Author(s):

Michelle A. Owens ◽

Benjamin M. Craig ◽

Kathleen M. Egan ◽

Damon R. Reed

Keyword(s):

Risk Factors ◽

General Population ◽

Potential Risk ◽

Online Survey ◽

Common Factor ◽

Reproductive Decisions ◽

Childbearing Age ◽

Potential Risk Factors ◽

Risk Factors For Recurrence ◽

The Impact

OBJECT To the authors' knowledge, no previous study has examined the impact of meningioma diagnosis on women's birth desires and intentions. In an exploratory study, the authors surveyed women affected by meningioma to determine their attitudes toward childbearing and the influences, including physician recommendations, on this major life decision and compared their responses to those of women in the general population. METHODS Meningioma survivors from the Meningioma Mommas online support group participated in an online survey that included questions on their birth desires and intentions, whether the risk of disease recurrence influenced their reproductive decisions, and risks communicated to them by their physicians. Using chi-square and rank-sum tests, the authors compared the survey participants' responses with those of the general population as assessed by the 2006–2010 National Survey of Family Growth. Logistic regression was used to adjust for differences in age, race, ethnicity, education, parity, pregnancy status, and infertility status in these populations. RESULTS Respondents with meningioma were more likely than those in the general population to report wanting a baby (70% vs 54%, respectively), intending to have a baby (27% vs 12%, respectively), and being very sure about this intention (10% vs 2%, respectively). More than half (32 of 61) of the women of childbearing age reported being advised by a physician about potential risk factors for recurrence of the meningioma, and pregnancy was the most commonly cited risk factor (26 of 61). The most common factor influencing birth desires and intentions was risk of the meningioma returning and requiring more treatment, which was reported by nearly two-thirds of the women in their childbearing years. CONCLUSIONS A majority of the meningioma survivors of childbearing age who completed the survey reported a desire for children, although concern about the risk of meningioma recurrence was an important factor for these women when making reproductive decisions. Physicians are in a position to educate their patients on potential risk factors for recurrence and to provide contact information for services such as counseling and family planning.

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Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

Clinical Infectious Diseases ◽

10.1093/cid/ciab791 ◽

2021 ◽

Author(s):

Milou Ohm ◽

Susan J M Hahné ◽

Arie van der Ende ◽

Elizabeth A M Sanders ◽

Guy A M Berbers ◽

...

Keyword(s):

The Netherlands ◽

Incidence Rate ◽

Vaccination Programme ◽

Screening Method ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Mass Campaign ◽

Conjugate Vaccination ◽

The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

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The impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1998.tb10264.x ◽

1998 ◽

Vol 105 (9) ◽

pp. 998-1004 ◽

Cited By ~ 14

Author(s):

Tracy Cheffins ◽

Annabelle Chan ◽

Rosemary J Keane ◽

Eric A. Haan ◽

Robert Hall

Keyword(s):

South Australia ◽

Congenital Rubella Syndrome ◽

Congenital Rubella ◽

The Impact

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Sex differences in invasive pneumococcal disease and the impact of pneumococcal conjugate vaccination in the Netherlands, 2004 to 2015

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.10.30481 ◽

2017 ◽

Vol 22 (10) ◽

Cited By ~ 3

Author(s):

Gertjan H J Wagenvoort ◽

Elisabeth A M Sanders ◽

Bart J Vlaminckx ◽

Hester E de Melker ◽

Arie van der Ende ◽

...

Keyword(s):

Sex Differences ◽

The Netherlands ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Age Groups ◽

Temporary Increase ◽

Long Term Effects ◽

Vaccine Introduction ◽

Ongoing Surveillance ◽

The Impact

Implementation of pneumococcal conjugate vaccines in the Netherlands (PCV7 in 2006 and PCV10 in 2011) for infants caused a shift in serotypes in invasive pneumococcal disease (IPD). We explored sex differences in serotype-specific IPD incidence before and after vaccine introduction. Incidences in the pre-PCV7 (June 2004–May 2006), post-PCV7 (June 2008–May 2011) and post-PCV10 period (June 2013–May 2015), stratified by age, were compared. Incidence was higher in men for all age groups (overall in men: 16.7, 15.5 and 14.4/100,000 and women: 15.4, 13.6 and 13.9/100,000 pre-PCV7, post-PCV7 and post-PCV10, respectively), except for 20–39 year-olds after PCV7 and 40–64 year-olds after PCV10 introduction. After PCV7 and PCV10 introduction, the overall IPD incidence decreased in men aged 20–39 years (from 5.3 pre-PCV7 to 4.7 and 2.6/100,000 post-PCV7 and post-PCV10, respectively), whereas it showed a temporary increase in women (from 3.9/100,000 pre-PCV7 to 5.0/100,000 post-PCV7 and back to 4.0/100,000 post-PCV10) due to replacement disease. PCV10 herd effects were observed throughout, but in women older than 40 years, a significant increase in non-PCV10 serotype offset a decrease in overall IPD incidence. Ongoing surveillance of IPD incidence by sex is important to evaluate the long-term effects of PCV implementation.

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A Serological Study of the Immune Status to Rubella in a Community in Singapore

Asia Pacific Journal of Public Health ◽

10.1177/101053958700100204 ◽

1987 ◽

Vol 1 (2) ◽

pp. 12-15

Author(s):

T W Wong ◽

YC Chan ◽

HC Tan

Keyword(s):

Immune Status ◽

Age Groups ◽

Immunisation Programme ◽

Latex Agglutination ◽

Reproductive Age ◽

Congenital Rubella ◽

Agglutination Method ◽

The Impact ◽

Reproductive Age Group ◽

Rubella Antibody

In 1986, a seroepidemiological study on rubella antibody was conducted in a public housing community in Singapore using the direct latex agglutination method. The overall seropositive rate was 78.1% (95% confidence limit: 73.5% to 82.7%). There was no significant association between age and immune status for both sexes. However, the seropositive rates for females aged 15 to 19 years and 20 to 24 years were significantly higher than for females in other age groups, reflecting the impact of the rubella immunisation programme launched in 1976. There is still a considerable number of susceptible females in the reproductive age group. An extension of the present programme to cover all persons above 12 months of age is recommended, as this would reduce the overall incidence of rubella, and hence congenital rubella, by conferring immunity to young children who presently act as reservoirs of infections.

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Vaccination against rubella and measles: quantitative investigations of different policies

Journal of Hygiene ◽

10.1017/s002217240002893x ◽

1983 ◽

Vol 90 (2) ◽

pp. 259-325 ◽

Cited By ~ 211

Author(s):

R. M. Anderson ◽

R. M. May

Keyword(s):

Mathematical Models ◽

Age Groups ◽

Term Effect ◽

Short Term ◽

Short Term Effect ◽

Congenital Rubella ◽

Theoretical Predictions ◽

The Impact ◽

Epidemiological Parameters ◽

Immunization Programmes

SUMMARYThis paper uses relatively simple and deterministic mathematical models to examine the impact that different immunization policies have on the age-specific incidence of rubella and measles. Following earlier work by Knox (1980) and others, we show that immunization programmes can, under some circumstances, increase the total number of cases among older age groups; the implications for the overall incidence of measles encephalitis and of congenital rubella syndrome are examined, paying attention both to the eventual equilibrium and to the short-term effect in the first few decades after immunization is initiated. Throughout, we use data (from the U.K., and U.S.A. and other countries) both in the estimation of the epidemiological parameters in our models, and in comparison between theoretical predictions and observed facts. The conclusions defy brief summary and are set out at the end of the paper.

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Increased awareness and knowledge of Lyme Borreliosis and tick bite prevention among the general population in France: 2016 and 2019 health barometer survey

BMC Public Health ◽

10.1186/s12889-021-11850-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Alexandra Septfons ◽

Julie Figoni ◽

Arnaud Gautier ◽

Noémie Soullier ◽

Henriette de Valk ◽

...

Keyword(s):

General Population ◽

Lyme Borreliosis ◽

Age Groups ◽

Tick Bite ◽

Tick Bites ◽

Protective Measures ◽

Information Campaigns ◽

Phone Survey ◽

Risk Areas ◽

The Impact

Abstract Background Lyme borreliosis (LB) is the most frequent tick-borne disease in France. In the absence of a vaccine, LB prevention mainly relies on reducing tick bites. In 2016, the French Ministry of Health launched a national plan against tick-borne infections, including a prevention component. To evaluate the impact of this prevention strategy, we assessed knowledge and practices of tick bite prevention using the 2016 and 2019 national surveys on health attitudes and beliefs known as the French Health Barometer. Methods The Health Barometer is a repeated nationwide phone survey conducted annually on a random sample aged 18 to 75 years living in mainland France. In 2016 and 2019, participants were asked, among others, about their exposure to ticks, their behavior and practices regarding tick bites, and their knowledge about LB and its prevention. Results In 2019, 30% of the population reported a lifetime tick bite and 6% in the last year, an increase from 25% and 4%, respectively, in 2016 (p < 0.001). In 2019, 25% of the population felt exposed to tick bites compared to 23% in 2016 (p < 0.001). The proportion of participants who had heard about LB and who considered themselves well informed respectively increased from 66% and 29% in 2016 to 79% and 41% in 2019, (p < 0.001). In 2019 compared to 2016, a greater part of the French population applied protective measures against tick bites, particularly wearing protective clothing (74% vs 66%, p < 0.001) and regular tick checks and prompt tick removal after exposure (54% vs 47%, p < 0.001). Conclusions A substantial proportion of French residents are exposed to tick bites and apply protective measures. Our findings indicate a trend toward an increased knowledge and awareness of tick bites and LB between 2016 and 2019 in France. Our results can be used to target future information campaigns to specific age groups or at-risk areas in addition to the general population. However, we need to further study the barriers to the use of preventive measures.

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