Hahné S J M, Abbink F, van Binnendijk R S, Ruijs W L M, van Steenbergen J E, de Melker H E
Rijksinstituutvoor Volksgezondheid en Milieu, Centrum Infectieziektenbestrijding, Postbus 1, 3720 BA Bilthoven.
Ned Tijdschr Geneeskd. 2005 May 21;149(21):1174-8.
Rubella is a public health problem due to the teratogenic effects associated with primary rubella infection during pregnancy (congenital rubella syndrome). Following universal rubella vaccination of infants in the Netherlands, the incidence of rubella has declined dramatically. However, since September 2004, an outbreak has occurred among unvaccinated individuals, most of whom declined vaccination based on religious beliefs. In the period 1 September 2004-22 March 2005, 166 cases of rubella were reported, including 12 pregnant women. Monitoring for signs that the epidemic has spread to other populations in the Netherlands is important because this might indicate the need for additional interventions. Awareness among health-care workers of the possible occurrence of congenital rubella syndrome should be raised. The clinical manifestations of congenital rubella syndrome are diverse, can be transient or permanent, and may not present until adolescence or adulthood. All cases of laboratory-confirmed rubella infection and congenital rubella syndrome should be reported to municipal health authorities. There is a possibility that this outbreak will spread abroad. The WHO aims to reduce the incidence of congenital rubella syndrome to < 1/100,000 live births. Health-care workers in the Netherlands should be extra alert to detect and notify rubella in a timely manner.
风疹是一个公共卫生问题,因为孕期原发性风疹感染会产生致畸作用(先天性风疹综合征)。在荷兰对婴儿进行普遍风疹疫苗接种后,风疹发病率大幅下降。然而,自2004年9月以来,未接种疫苗人群中出现了疫情,其中大多数人基于宗教信仰拒绝接种疫苗。在2004年9月1日至2005年3月22日期间,报告了166例风疹病例,其中包括12名孕妇。监测疫情是否已传播到荷兰其他人群很重要,因为这可能表明需要采取额外干预措施。应提高医护人员对先天性风疹综合征可能发生情况的认识。先天性风疹综合征的临床表现多种多样,可能是短暂的或永久性的,并且可能直到青春期或成年期才出现。所有实验室确诊的风疹感染和先天性风疹综合征病例均应报告给市政卫生当局。此次疫情有可能蔓延到国外。世界卫生组织的目标是将先天性风疹综合征的发病率降低至<1/100,000活产。荷兰的医护人员应格外警惕,及时发现并报告风疹病例。