Progress toward Rubella Elimination and CRS prevention in Europe

Venue: Atahotel Villa Pamphili

Location: Rome, Italy

Event Date/Time: Feb 08, 2012 End Date/Time: Feb 10, 2012
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Rubella is a self-limited febrile rash illness with few complications. Although rubella itself is a disease often causing only mild illness to those infected, a significant disease burden is associated with rubella virus infection during the first trimester of pregnancy. Known as congenital rubella syndrome (CRS) the disease manifests itself as a host of syndromes affecting babies born to mothers who were infected with rubella during pregnancy. The earlier the mother is infected during pregnancy the worse the damage is to the child.

According to the World Health Organization ‘When a woman is infected with the rubella virus early in pregnancy, she has a 90% chance of passing the virus on to her fetus. This can cause the death of the fetus, or it may cause CRS’.

CRS is an important cause of hearing and visual impairment as well as mental retardation in countries where rubella infection is not yet controlled or eliminated. CRS clinical manifestations can be grouped into three categories: 1. Conditions present at birth (eg. low birth weight); 2. Structural conditions that may be present at birth or become apparent during the first year of life (eg. deafness, blindness); 3.Conditions that emerge later in life (eg. diabetes mellitus)

According to the WHO the burden of CRS is not well documented in all countries. But even so an estimated 100,000 cases of CRS occur each year in developing countries alone. In the Western Hemisphere, approximately 20,000 children were born with CRS annually during non-epidemic periods, with CRS incidence rates increasing up to 1-4 per 1,000 live births during epidemic cycles.
Direct and indirect costs related to CRS are high due to the chronic nature and severity of symptoms, and the specialized diagnostic and treatment procedures required. The annual cost, including indirect costs, of treating an infant with CRS over a lifetime is estimated at US$63,000 in Caribbean Countries. In the United States, the lifetime cost of treating a patient with CRS is estimated to be more than $200,000. Recent estimates from Latin American countries suggest that the cost-benefit ratio of implementing a mass rubella vaccination campaign using measles-rubella (MR) vaccine is approximately 1:13, and that the average cost-effectiveness of such a campaign is close to US$4,100 per CRS case averted.

According to the World Health Organization (WHO) as of 2008 only 40% of the birth cohort is receiving rubella vaccines through National Immunization Programs. Notably the regions that still have not introduced the vaccine are the regions of Asia and Africa.