Vaccine 22 (2004) 4287–4290 Role of the virology diagnosis laboratory in the surveillance of rubella virus Cuba 1988/2000 Maria de los Angeles Ribas a,* , Miguel Galindo b , Gisset Torres a , Marlen Valcarsel b , Reynel Cancio a , Maria Guadalupe Guzm´ an a , Delfina Rosario a , Sonia Resik a , Carina Rodriguez a , Daneb Garcia a , Yahisel Tejero a a Pedro Kour´ ı Institute, Autopista Novia del Mediodia Km 61/2, La Lisa, P.O. Box 601, Marianao 13, Havana City, Cuba b Ministry of Public Health, 23 N. Vedado, Havana City, Cuba Received 15 January 2003; received in revised form 15 October 2003; accepted 23 April 2004 Abstract In Cuba, on the basis of Measles Elimination Program, the incidence of this disease decline, and was necessary to test rubella virus as a possible etiology agent that produce fever and rash illness. To reach this goal, Cuba developed rubella elimination strategies with integrated epidemiologic and laboratory surveillance. In the country, the vaccination program against rubella started in 1982 by vaccinating 12–14 years old females, with a special surveillance program with laboratory study of all suspected cases. Through 1988–2000, the Serology Diagnosis Laboratory in the Virology Branch of Pedro Kour´ ı Institute had the responsibility to do the measles and rubella surveillance and play a key roll in the elimination strategies of these diseases. For confirmation of all suspected cases, 8566 serum samples with the suspected diagnosis of measles or rubella from different provinces in Cuba were studied in the laboratory using different techniques as haemagglutination inhibition test (HIA), ultra micro analytic assay (UMA); and in 1995 by the newly introduced IgM ELISA, which was used taken only one sample in the acute phase of the disease. These techniques allowed knowing that the annual number of reported rubella cases in the country decreased substantially after the implementation, in 1986, of the second vaccine policy, that of vaccinating women of childbearing age. However, in 1989, was detected an outbreak of rubella virus infection that had occurred in young adults male 15–19 age groups in Matanzas’ province. The last three indigenous cases of this disease were confirmed by our laboratory in 1995, after national vaccine coverage over 95%. © 2004 Elsevier Ltd. All rights reserved. Keywords: Rubella; Surveillance; Vaccination program 1. Introduction Rubella virus infection is contagious, usually mild, and similar to other viral diseases with rash (measles, scarlatine, exanthema subitum, etc.) whose clinical symptoms include fever, lymphadenopathy, and joint pain with possible compli- * Corresponding author. Tel.: +53 7 220426–45x3204; fax: +53 7 336051/204651. E-mail address: maribas@ipk.sld.cu (M. de los Angeles Ribas). cations [1]. The wild virus circulation in men and women pro- vides a risk to non-immune pregnant women with the cost of this infection being congenital rubella syndrome (CRS) with a prevalence about 250,000 cases in the Americas [2–4]. Pan American Health Organization (PAHO) and Health authorities in Cuba, involved in measles elimination program, decide to include a rubella elimination program developing different strategies with the objective to eliminate the CRS. During the course of the school years 1982–1983, the first strategy was addressed to vaccinate against rubella 0264-410X/$ – see front matter © 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.vaccine.2004.04.023