Strategies to eradicate rubella in the English-speaking Caribbean

Objective. This report presents the strategies used to eradicate rubella in the Caribbean region and the challenges faced by that effort. Methods. Using the surveillance system fur measles cases that was institute d in all countries in the Caribbean Community (CARICOM), 12 countries confi rmed cases of rubella between 1992 and 1996. Rubella infections occurred in epidemic proportions in 6 countries during that period. Results. On the basis of the rubella prevalence data, rubella-congenital ru bella syndrome (CRS) cost-benefit analysis, and cost-effectiveness of the m ass campaign, the Council for Human and Social Development of CARICOM resol ved, on April 21, 1998, that every effort would be made to eradicate rubell a, as well as to prevent the occurrence of new cases of CRS by the end of 2 000. Using the Pan American Health Organization's template for measles erad ication, CARICOM proposed and implemented the main strategies for rubella a nd CRS eradication, and rubella mass campaigns were conducted in 18 countri es. The target population, which included males and females (aged 20-40 yea rs), was approximately 2.2 million. Conclusion. The major challenges for rubella eradication are attaining high vaccine coverage in the adult population and maintaining an effective surv eillance system able to detect rubella activity.