Epidemiology and Infection

The pre-vaccination epidemiology of measles, mumps and rubella in Europe: implications for modelling studies

W. J. EDMUNDS a1c1, N. J. GAY a1, M. KRETZSCHMAR a2, R. G. PEBODY a1 and H. WACHMANN a3 1
a1 Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London, NW9 5EQ, UK
a2 Department of Infectious Diseases Epidemiology, RIVM, Postbus 1, 3720 Bilthoven, The Netherlands
a3 Staten Serum Institute, 5 Artillerivej, 2300 Copenhagen S, Denmark


Data on the pre-vaccination patterns of infection for measles, mumps and rubella are collated from a number of European countries in order to compare the epidemiology of the three viruses. Key epidemiological parameters, such as the age-specific force of infection and the basic reproduction number (R0) are estimated from case notification or serological data using standard techniques. A method is described to compare force of infection estimates derived from serological data. Analysis suggests that the pre-vaccination patterns of measles and mumps infection in the different countries were similar. In contrast, the epidemiology of rubella was highly variable between countries. This suggests that it may be acceptable to use parameter values estimated from other countries to model measles and mumps transmission, but that this approach to modelling rubella transmission requires more caution. Estimates of R0 depend on underlying mixing assumptions. Constraints were placed on R0 estimates by utilising knowledge of likely mixing patterns. The estimates for R0 were highest for measles, intermediate for mumps, and generally lowest for rubella. Analysis of within- and between-age-group transmission rates suggested that mumps transmission tends to be more concentrated within young children than the other two viruses. The implications for the design of immunization programmes are that mumps may be the easiest to control via infant immunization since it is predominantly transmitted between the very young and the variability in rubella epidemiology requires that careful consideration of the possible effects of vaccination options should be made using local data when planning rubella immunization programmes.

(Accepted June 5 2000)

c1 Author for correspondence.


1 on behalf of the ESEN Project