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Surveillance for congenital rubella in Australia since 1993: cases reported between 2004 and 2013
Gulam Khandaker1, Yvonne Zurynski2, Cheryl Jones3
1Centre 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.
Insights
Congenital rubella infections in Australia primarily affect infants born to unvaccinated immigrant mothers. Targeted vaccination of migrant women is crucial to prevent congenital rubella syndrome (CRS).
Area of Science:
- Epidemiology
- Infectious Diseases
- Paediatrics
Background:
- Congenital rubella infection (CRI) poses significant risks, leading to congenital rubella syndrome (CRS).
- Understanding the epidemiology of CRI is essential for public health interventions.
- The Australian Paediatric Surveillance Unit (APSU) has monitored CRI since 1993.
Purpose of the Study:
- To analyze the epidemiology of CRI cases notified to the APSU between 2004 and 2013.
- To compare recent CRI data with historical data from 1993-2003.
Main Methods:
- Active national surveillance through the APSU.
- Monthly reporting by child health clinicians based on defined case criteria.
- Extraction and analysis of de-identified clinical, epidemiological, and laboratory data.
Main Results:
- Five confirmed CRI cases were identified between 2004-2013, all with CRS.
- Four infants were born in Australia to overseas-born mothers, with three unvaccinated.
- Since 1993, 57 CRI notifications were received, with 40 infants born between 1993-2013, 34 with confirmed CRS.
Conclusions:
- CRI in Australia predominantly affects infants of unvaccinated immigrant mothers.
- Vaccination programs targeting migrant women from rubella-endemic countries are vital.
- Pregnant women should assess risks of travel to rubella-endemic areas.
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.
