THE INCIDENCE OF RUBELLA-VIRUS INFECTIONS IN SWITZERLAND AFTER THE INTRODUCTION OF THE MMR MASS VACCINATION PROGRAM

We have collected data on the incidence of rubella in Switzerland from 1987 to 1992 to help evaluating the impact of the measles, mumps and rubella (MMR) mass vaccination programme which started in 1985 in this country. We used detailed informations on samples submitted for diagn ostic testing in conjunction with anonymous laboratory notifications t o the Swiss Federal Office for Public Health, and data from the Swiss sentinel network of general practitioners to find trends in the incide nce of rubella after the introduction of mass vaccination. We observed an unabated seasonal oscillation without decreasing trend during the observation period and were unable to detect a shift in the age distri bution of cases. An important proportion of laboratory-confirmed rubel la occurred in women of childbearing age. Immigrants from regions with low endemicity of rubella were at increased risk of contracting rubel la and transmitting it to their offspring. We conclude, that MMR mass vaccination has not interrupted the circulation of rubella virus in Sw itzerland, and that improvements in the implementation and surveillanc e of the MMR vaccination campaign are necessary in order to avoid unto ward effects of it.