Rubella: 2016 Epidemiological Data
In 2016, the Rénarub network comprised 138 laboratories nationwide, including 132 in mainland France and 6 in the overseas departments. The effective participation rate of the laboratories surveyed was 70% (laboratories participating in both survey semesters), with 80% of laboratories participating in at least one survey semester. The return rate for completed forms by clinicians who treated the patients was 100% (58 forms).
Three confirmed maternal rubella infections, including 2 reinfections, were recorded in mainland France; none were reported in the overseas departments and territories.
|
|
2005 |
2006 |
2007 |
2008 |
2009 |
2010 |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Number of cases reported by laboratories (IgM+) |
110 |
118 |
75 |
65 |
144 |
123 |
140 |
149 |
151 |
92* |
89 |
105 |
|
Excluded cases |
94 |
111 |
70 |
63 |
137 |
119 |
132 |
136 |
139 |
86 |
88 |
98 |
|
Possible primary or reinfection |
5 |
7 |
4 |
7 |
14 |
6 |
5 |
6 |
0 |
1 |
2 |
4 |
|
Lost track of, files not returned |
9 |
26 |
4 |
31 |
47 |
23 |
12 |
17 |
2 |
2 |
6 |
5 |
|
Other** |
80 |
78 |
62 |
25 |
76 |
90 |
115 |
113 |
137 |
83 |
80 |
89 |
|
Confirmed and probable maternal rubella infections |
16 |
7 |
5 |
2 |
7 |
4 |
8 |
13 |
12 |
6 |
1 |
7 |
|
Confirmed primary infections |
11(a) |
3 |
4 |
1 |
5 |
2 |
5 |
12 |
10 |
3 |
1 |
5 |
|
Confirmed re-infections |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
1 |
0 |
0 |
0 |
|
Confirmed infections |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Probable primary infections |
2 |
2 |
1 |
0 |
1 |
1 |
3 |
0 |
1 |
3 |
0 |
0 |
|
Probable re-infections |
1 |
1 |
0 |
1 |
1 |
1 |
0 |
1 |
0 |
0 |
0 |
2 |
|
Probable infections |
0 |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Number of congenital infections |
9 |
0 |
2 |
0 |
2 |
1 |
2 |
3 |
5 |
2 |
1 |
0 |
|
Congenital rubella syndrome (newborns) |
2 |
0 |
0 |
0 |
1 |
0 |
1 |
0 |
3 |
2 |
1 |
0 |
|
Teratogenic rubella (termination of pregnancy) |
0 |
0 |
0 |
0 |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Non-malformative rubella infection or unknown clinical status (newborns or fetuses) |
7 |
0 |
2 |
0 |
0 |
1 |
1 |
3 |
2 |
0 |
0 |
0 |
In 2016, the ratio of “rubella infections during pregnancy reported by Renarub per 100,000 live births” in mainland France was 0.40.
Trends in the ratio of rubella infections among pregnant women to live births – Metropolitan France, 1976–2016 (MMR = trivalent measles-mumps-rubella vaccine)
A mother who had been reinfected gave birth to a child who was not infected. The pregnancies were terminated voluntarily in the case of the mother with a new infection and medically in the case of the second mother who had been reinfected; the clinical status and infection status of the fetuses were not determined.
Trends in the number of maternal infections leading to pregnancy terminations or the birth of children with congenital rubella syndrome – 1997 to 2016
The ratio of "newborns with congenital rubella syndrome (CRS) reported by Rénarub to the number of live births (LB)" in mainland France was 0.0 per 100,000.
Trends in the ratio of rubella infections among pregnant women to cases of congenital rubella syndrome among live births – Metropolitan France, 2001–2016
The mother’s country of birth was documented for all 7 maternal infections; 4 were born outside France (2 in the Maghreb and 2 in sub-Saharan Africa). There were no clusters of cases, and the 3 locally acquired maternal infections were distributed throughout the country.
Data collected through the Rénarub network in 2016 continue to indicate low residual circulation of the rubella virus, reflecting a high level of immunity among women of childbearing age due to catch-up vaccination.
This level of susceptibility to the virus was estimated at 3.1% in mainland France among women aged 18 to 32 in the seroprevalence survey conducted among blood donors in 2013. However, the level of susceptibility is higher among men (7.8%), and vaccination coverage rates in France vary by department, which could facilitate the emergence of localized outbreaks of viral circulation.
The actual number of maternal infections may be underestimated within the Rénarub network, primarily due to a lack of diagnosis in pregnant women, as rubella infections are frequently asymptomatic or atypical.
The active participation, since the creation of Rénarub, of specialized laboratories—which receive control samples when a maternal infection is suspected—suggests that even if the network is not entirely comprehensive, and even if the participation rate of all laboratories or clinicians is not 100%, the vast majority of confirmed and probable cases are captured by the surveillance system.
