History of rubella in Pará State, Brazil: towards eradication

Abstract

OBJECTIVE: To describe the rubella trajectory using seroepidemiological profile of individuals referred to Instituto Evandro Chagas (IEC) between 1989 and 2012, and to compare the results before and after rubella vaccine introduction in Pará State, Brazil, through the National Immunization Program. 
METHODS: Retrospective study analyzing the results of tests for detection of IgG and IgM antibodies to rubella virus by ELISA method in 50,439 individuals from different age groups, who were directed to IEC for diagnosis of exanthematous diseases in 1989-1999 (before the vaccine), and 2000-2012 (after the vaccine). 
RESULTS: The rubella prevalence in this study presented a relevant decrease in infection from 17.26% to 2.23% after the vaccination period; immunity frequency increased from 48.30% to 79.39%; susceptibility was reduced from 34.54% to 18.38%. Infected pregnant women were 9.3% before the vaccination period and 0.6% after the vaccination period. A total of 37 cases of congenital rubella syndrome (CRS) were recorded in the prevaccination period, and 11 after it. From 2010 to 2012, there were no records of autochthonous cases of either that disease or CRS. 
CONCLUSION: Strengthening of epidemiological surveillance, training for health professionals in eradication plans with monitoring services, and vaccination strategies with the introduction of rubella vaccine in the routine schedule had a great impact on reducing rubella and CRS cases, contributing to eradication.