The seroepidemiology of rubella in western Europe

Most of the countries in western Europe have now implemented mass infant ru bella immunization programmes, instead of or in addition to selective vacci nation in order to achieve the elimination of congenital rubella syndrome. The European countries Denmark, England and Wales, Finland, France, Germany , Italy and the Netherlands undertook large, national serological surveys c ollecting several thousand serum specimens during 1994-8, Antibodies agains t rubella virus were detected by a variety of enzyme immune-assays. Compara bility of the assay results was achieved by a standardized methodology. The age- and sex-stratified serological results were related to the schedules, coverage of rubella vaccination and the incidence in these countries. The results show widely differing levels of immunity to rubella both in the general population and in the specific age groups of males and females. A low rate (<5%) of susceptibles in childhood and adolescents of both sexes w as obtained only in Finland and the Netherlands. Countries such as Italy with only moderate coverage for the infant immuniza tion programme currently have both high susceptibility levels in the genera l population and in the at-risk population. The likelihood is of continued epidemics of rubella with cases of congenital rubella syndrome. The continu ed implementation of selective vaccination will help to offset the impact o f this ongoing transmission and to protect women on reaching childbearing a ge.