The estimate of the rubella elimination status in the Russian Federation in 2019
In 2002, the WHO Regional Office for Europe developed a Strategic Program for the Prevention of Measles and Congenital Rubella Infections in the European Region, which was revised in 2004. As a result of the revision, an additional target was set to eliminate endemic rubella in the region by 2010. Rubella is a disease that is well controlled by vaccination, which will determine the theoretical possibility of interrupting its global transmission. Since 2013, the Russian Federation has been implementing the National Rubella Elimination Program. Elimination criteria have been revised as the Program progresses. Currently, the main criterion for rubella elimination is the absence of endemic (local) transmission of the virus for at least 36 months, which should be confirmed by molecular genetic research methods. In addition, in the Russian Federation, an incidence rate of less than 1 case per 1 million population is also used as one of the elimination criteria. The successful implementation of the Program is supported by the fact that since 2013, against the background of a high (over 95%) coverage of preventive vaccinations, there has been a decrease in incidence rates and their stabilization at a level of less than 1 per 1 million population since 2014. Genetic monitoring of rubella virus strains circulating among the population showed the termination of endemic transmission of the virus. During the implementation of the Elimination Program, the prevailing genotypes of the virus circulating in Russia were genotypes 1E and 2B, which have a global distribution. The data obtained from the results of molecular genetic monitoring made it possible to determine that the strains isolated during the period under consideration belong to different clusters, which speaks in favour of their imported character. Considering the above factors: high vaccination coverage, low incidence and lack of endemic transmission of the virus, the WHO Committee on verification of measles and rubella elimination in 2017 awarded the Russian Federation the status of a country that has achieved rubella elimination. The continuation of the phase of elimination of infection is confirmed annually. This article presents the results of a comprehensive assessment of the rubella elimination status in the Russian Federation by specialists from the National Scientific and Methodological Center for Measles and Rubella and WHO EURO Moscow regional reference laboratory for measles and rubella based on epidemiological data and data from molecular genetic studies in 2019.