Australian vaccine preventable disease epidemiological review series: rubella 2008-2012.

INTRODUCTION Since the introduction of universal rubella vaccination in 1989, the incidence of rubella and congenital rubella syndrome (CRS) in Australia has declined significantly. Worldwide, there has been a focus on elimination, with the region of the Americas declaring rubella elimination in 2011. This study aims to review Australian rubella epidemiology for the 2008-2012 period, in the context of historical and international trends. METHODS Notification, hospitalisation and mortality data were sourced from the National Notifiable Diseases Surveillance System, the National Hospital Morbidity Database and the Australian Bureau of Statistics (ABS). Data analysis focused on 2008-2012 for notifications and 2008-2011 for hospitalisations and deaths. ABS population data were used to calculate rates. RESULTS The average annual rubella notification rate in Australia from 2008-2012 was 0.18 per 100,000 and the average annual hospitalisation rate was 0.03 per 100,000 from 2008-2011. One case of CRS was notified in 2012 and 1 hospitalisation with a principal diagnosis of CRS was recorded in 2008. The median age of rubella notifications was 29 years and 37% of notifications were for infections acquired overseas. DISCUSSION Rubella continues to be well controlled in Australia and CRS is rare. The low incidence and increasing proportion of imported cases and other evidence suggest that elimination has been achieved; however, for formal verification of rubella elimination the expansion of genotypic surveillance will be required. Ongoing rubella control needs to focus on improved surveillance, maintenance of high levels of vaccine coverage, vaccination of at-risk populations in Australia, and regional and global efforts towards rubella elimination.