Epidemiology and Infection

Measles, mumps, rubella and fifth disease

An outbreak of rubella in the Federation of Bosnia and Herzegovina between December 2009 and May 2010 indicates failure to vaccinate during wartime (1992–1995)

M. HUKICa1, J. M. HÜBSCHENa2, M. SEREMETa1, I. SALIMOVIC-BESICa1, M. MULAOMEROVICa3, N. MEHINOVICa4, S. KARAKASa5, E. CHARPENTIERa2 and C. P. MULLERa2 c1

a1 Institute of Clinical Microbiology, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

a2 Institute of Immunology, WHO European Regional Reference Laboratory for Measles and Rubella, Centre de Recherche Public-Santé/Laboratoire National de Santé, Luxembourg, Luxembourg

a3 Institute of Public Health of Federation Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina

a4 Institute of Public Health of Tuzla Canton, Tuzla, Bosnia and Herzegovina

a5 Institute of Public Health of Central Bosnia Canton, Travnik, Bosnia and Herzegovina

SUMMARY

A rubella outbreak involving 1900 cases was recorded in the Federation of Bosnia and Herzegovina between mid-December 2009 and the end of May 2010. Sera from 389 suspected rubella cases were examined for the presence of rubella-specific IgM and IgG antibodies. A total of 32 throat swabs from suspected rubella cases were tested by RT–PCR and were used to attempt virus isolation. Most patients (945/1900, 49·73%) had never received rubella vaccination or had an unknown vaccination status (563/1900, 29·63%). About 45% (178/389) of suspected rubella patients were IgM positive. From 13 of the throat swabs a virus isolate and E1 gene sequences attributed to genotype 2B were obtained. The rubella outbreak was due to failure to vaccinate during the war period (1992–1995) and emphasizes the need for additional vaccination opportunities.

(Accepted March 22 2011)

(Online publication April 28 2011)

Correspondence:

c1 Author for correspondence: Prof. Dr. C. P. Muller, Institute of Immunology, Centre de Recherche Public Santé/Laboratoire National de Santé, 20A rue Auguste Lumière, L-1950 Luxembourg. (Email: claude.muller@LNS.ETAT.LU)

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