The WHO Regional Committee for Europe adopted the goal of eliminating indigenous measles transmission in 1998. In 2005, the Regional Committee expanded this commitment to include rubella and set a date for the elimination of both diseases by 2010. Although Member States did make progress, through the implementation of a strategic plan, the goal was not achieved. The WHO Regional Committee for Europe acknowledged at its sixtieth session (2010) that the regional goal of eliminating measles and rubella is achievable, and set a new target date of 2015.

In the document Eliminating measles and rubella and preventing congenital rubella infection, WHO European Region strategic plan 2005–2010, key strategies are identified to meet the targets for interrupting transmission of indigenous measles and rubella and preventing congenital rubella infection. Strengthening surveillance systems by vigorous case investigation, including laboratory confirmation, is one of these key strategies.

In line with the elimination goal, Surveillance guidelines for measles, rubella and congenital rubella syndrome in the WHO European Region are intended to provide technical advice on the design and implementation of surveillance programmes. Surveillance indicators defined in these guidelines will be critical for assessing whether Member States have achieved the level of disease surveillance necessary for documenting elimination of indigenous measles and rubella transmission, and verifying that the Region's elimination objectives have been reached.

Contents

• Acknowledgments
• Acronyms
• 1. Introduction
  • 1.1 Objectives of surveillance and programme monitoring
• 2. Measles, rubella and CRS: disease description, epidemiology and diagnosis
  • 2.1 Measles
  • 2.2 Rubella
  • 2.3 Congenital rubella syndrome
  • 2.4 Rationale for disease elimination and an integrated approach to measles and rubella surveillance in the European Region
• 3. Case definitions for surveillance and reporting of measles and rubella
  • 3.1 Measles
  • 3.2 Rubella
  • 3.3 Classification of cases by origin of infection
  • 3.4 Measles and rubella outbreaks
• 4. Measles and rubella surveillance
  • 4.1 Laboratory assessment algorithms for measles and rubella infection
  • 4.2 Data collection and reporting
  • 4.3 Reporting to WHO
• 5. Monitoring and evaluation
  • 5.1 Surveillance performance indicators
  • 5.2 Indicators for monitoring progress towards elimination
• 6. Surveillance of CRS
  • 6.1 Rationale
  • 6.2 CRS – clinical features, case classification and laboratory criteria for confirmation
  • 6.3 CRS surveillance
  • 6.4 Other approaches to identifying CRS cases
• References
• Annexes
  • Annex I Integrated measles and rubella case investigation form
  • Annex II Measles and rubella database for case-based reporting – CISID
  • Annex 3 Collection, storage and shipment of specimens for laboratory diagnosis and interpretation of results
  • Annex 4 Measles/rubella aggregate outbreak reporting form
  • Annex 5 Congenital rubella syndrome case investigation form
  • Annex 6 Steps for establishing a CRS surveillance system

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