Epidemiology of Rubella and Congenital Rubella Infection in Israel, A Country with a Selective Immunization Program

A rubella immunization program directed at girls aged 12 years started in Israel in 1973, and its extension in 1980 to women of childbearing age had produced by 1983 several changes in the epidemiologic pattern of rubella infection in women of childbearing age and in the risk of congenital rubella: (1) a 55%-77% decline in the incidence of the disease in the 15-44-year age group; (2) a progressive reduction in the rate of seronegativity among women from >20% to <10%; (3) a risk of infection during pregnancy and a percentage of abortions associated with rubella infection in the 1983 outbreak that were one-twelfth and one-tenth, respectively, the values associated with the 1978 and 1979 epidemics; and (4) an evident decrease in the frequency of cases of congenital rubella, as detected by either passive or active surveillance. It is predicted that of the women who will be pregnant in 1985, 98.2% and 94.3% of those in the 18-23 year and 24-44 year age groups, respectively, will be immune by the end of 1984.