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Rubella amongst suspected measles cases under the EPI surveillance program in Zambia (2004-2011)

2012; Elsevier BV; Volume: 16; Linguagem: Inglês

10.1016/j.ijid.2012.05.310

1878-3511

Mazyanga L. Mazaba Liwewe, Idah Ndumba, Julia N. Chibumbya, T. Msiska, Helen Mutambo, C. Micheelo, Olusegun Babaniyi, Mwaka Monze,

Virology and Viral Diseases

Background: Zambia, a Southern African country with a population of 13,881,336 (July 2011 est) has reported 1096 laboratory confirmed rubella cases amongst 4742 suspected measles cases investigated between 2004 and 2011. Rubella though not a notifiable disease in Zambia, is a significant disease amongst young women in childbearing age causing serious consequences including miscarriage, fetal death or an infant born with defects (i.e., Congenital Rubella Syndrome. [S E Reef etal, The Journal of Infectious Diseases, 2011;204:S24-S27] Though in 2009 Zambia was included amongst the 22 WHO member states that met the criteria for the introduction of a rubella-containing vaccine (RCV), there is no RCV given through the Rotine Immunisation (RI). In 2003 enhanced strategies to address the continued incidence of measles were put in place including case based laboratory-backed measles surveillance to capture the disease and interrupt further transmission timely (recommended by WHO & UNICEF). Samples are routinely collected from sporadic cases children under 15 years of age suspected of measles infection or first five cases in an outbreak from all over the country. A suspected measles case is defined as a person presenting with fever, and rash and or cohryza. Methods: All samples received are tested for measles IgM using an enzyme-linked immunoabsorbent assay (ELISA) testing method by the national measles laboratory accredited by WHO. Though Zambia has no specific goals relating to elimination or control of rubella disease and its consequences, all samples that test negative for measles IgM are tested for Rubella IgM using an ELISA method. Results: From 2004 to 2011, a total of 1096 (23.1%)/4742 rubella cases have been confirmed amongst persons investigated for measles. Annual trends show peaks of rubella infection in 2004, 2005, 2008, and 2009 when measles positivity was low. The seasonality pattern indicates most cases of Rubella occurring from August to December which is the hot season followed by the rainy season. The incidence of Rubella is highest amongst those in the age group from 5 – 14 years Conclusion: Though the study population is limited to those below 15 years, the results indicate that Rubella disease exists in Zambia.