A large rubella outbreak, Romania--2003.

Romania experienced a large rubella outbreak in 2002-03, with more than 115,000 reported cases nationwide, and an incidence of 531 reported cases per 100,000 population. The incidence was highest in children of school age. The cohorts of adolescent girls vaccinated in 1998 and 2002 (when a rubella-containing vaccine was available) had significantly lower incidence rates (p<0.001) compared with those in boys in the same age groups who were not vaccinated. In 2003, of the 150 suspected congenital rubella syndrome (CRS) cases reported, seven (4.6%) were confirmed by positive rubella IgM antibodies. In the absence of available rubella containing vaccine for outbreak control, an outbreak response plan to improve the detection of cases and to limit rubella virus transmission was developed. The following activities were conducted: surveillance of pregnant women with suspected rubella or history of exposure to rubella virus was implemented, with follow up of pregnancy outcomes; surveillance for CRS was strengthened; existing infection control guidelines to prevent disease transmission within healthcare facilities were reinforced; and a communication plan was developed. In May 2004, Romania is introducing measles, mumps and rubella (MMR) vaccine for routine vaccination of children aged 12 to 15 months, while continuing vaccination of girls in the 8th grade of school (13-14 years of age) with rubella-only vaccine.

Malaria in the whole world and in Romania.

Malaria is the world's most important tropical parasitic disease. Malaria is a public health problem today in more than 90 countries. Worldwide prevalence of the disease is estimated to be in the order of 300-500 million clinical cases each year. Malaria is endemic in a total of 101 countries and territories. In Romania, malaria does not represent an important public health problem. In 1999, there were reported a total number of 32 malaria cases in Romanian people. 78% from these recognized as etiological agent Pl. falciparum. The malaria cases imported from Turkey (5) have had as etiological agent Pl. vivax. The most affected age group is between 21-50 years and a distribution by profession shows that sailor personnel accounts for 65.6% of all cases. Africa remains the most important endemic region from where the malaria cases in Romanian people are imported. An adequate chemoprophylaxis is not, yet, easy to obtain for Romanian people who are travelling abroad in endemic countries because of the lack of specific drugs (especially for resistant forms of Pl. falciparum). Even if the Romanian Ministry of Health had elaborated orders regarding malaria and Cloroquine is the usual drug administered, as chemoprophylaxis, to Romanian people who travel abroad, in each year in our country appears around 30-60 imported malaria cases. That is the cause why Romanian Ministry of Health wants to solve this problem which is the major cause of the malaria cases in Romanian people.