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Given that little is known about rubella in Africa, the authors provide an overview of published sero-prevalence surveys and analysis of surveillance and laboratory data as a baseline of prevaccine-era rubella epidemiology in Africa, in preparation for the introduction and widespread use of rubella vaccine throughout the region. The report documents that 1) rubella virus is circulating widely in Africa and primarily infects young children, 2) by 15 years of age most children have developed immunity from natural infection, 3) 5% of reported rubella cases occurred in women of reproductive age, suggesting that rubella infection during pregnancy, which can potentially lead to CRS occurs throughout the region. The authors conclude by recommending careful introduction of rubella vaccination to ensure that rubella immunity among women of reproductive age is assured. More details on this maiden review and analysis of Rubella in Africa is available at: http://jid.oxfordjournals.org/content/204/suppl_1/S215.long