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Epidemiology of rubella and congenital rubella infection in Israel, a country with a selective immunization program
Insights
Israel
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Rubella immunization programs targeting young girls began in Israel in 1973.
- The program expanded in 1980 to include women of childbearing age.
Purpose of the Study:
- To evaluate the impact of a rubella immunization program on rubella infection and congenital rubella risk in women of childbearing age.
- To assess changes in rubella epidemiology and seronegativity rates.
Main Methods:
- Analysis of rubella infection incidence and seronegativity rates in women aged 15-44 years.
- Comparison of rubella infection risk and abortion rates during outbreaks before and after program expansion.
- Surveillance of congenital rubella cases.
Main Results:
- A 55%-77% decline in rubella incidence among women aged 15-44.
- Seronegativity reduced from over 20% to under 10%.
- Significant reductions in infection risk and rubella-associated abortions during the 1983 outbreak compared to previous epidemics.
Conclusions:
- The rubella immunization program effectively reduced rubella infection and congenital rubella risk in women of childbearing age.
- High immunity levels are predicted among women of childbearing age by 1985.
- Public health interventions can significantly alter disease epidemiology.
Abstract:
A rubella immunization program directed at girls aged 12 years started in Israel in 1973, and its extension in 1980 to women of childbearing age had produced by 1983 several changes in the epidemiologic pattern of rubella infection in women of childbearing age and in the risk of congenital rubella: a 55%-77% decline in the incidence of the disease in the 15-44-year age group; a progressive reduction in the rate of seronegativity among women from greater than 20% to less than 10%; a risk of infection during pregnancy and a percentage of abortions associated with rubella infection in the 1983 outbreak that were one-twelfth and one-tenth, respectively, the values associated with the 1978 and 1979 epidemics; and an evident decrease in the frequency of cases of congenital rubella, as detected by either passive or active surveillance. It is predicted that of the women who will be pregnant in 1985, 98.2% and 94.3% of those in the 18-23 year and 24-44 year age groups, respectively, will be immune by the end of 1984.