Documenting the elimination of measles rubella and congenital rubella syndrome in Ontario: 2009-12.

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Can Commun Dis Rep. 2014 Apr 17;40(8):143-151. eCollection 2014 Apr 17.

Documenting the elimination of measles rubella and congenital rubella syndrome in Ontario: 2009-12.

Lim GH1 Deeks SL12 Fediurek J1 Gubbay J134 Crowcroft NS124.

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Under the guidance of the Pan American Health Organization (PAHO) countries of the Americas are currently documenting the elimination of measles rubella and congenital rubella syndrome.


This paper describes Ontarios progress in documenting the elimination of these conditions between 2009 and 2012.


All possible case classifications including those that did not meet surveillance case definitions were extracted from the provincial reportable disease database the integrated Public Health Information System (iPHIS). Data were analyzed against select criteria specified by the PAHO specifically with respect to epidemiology vaccination coverage and the quality of the surveillance system.


There were no known endemic cases of measles rubella or congenital rubella syndrome reported in Ontario during the study period. Cases were predominantly the result of importation as these diseases remain endemic in many countries. A total of 27 confirmed cases of measles were reported over the four-year period most of which could be verified as being directly or indirectly linked with travel outside Canada. In addition five confirmed cases of rubella and one case of imported congenital rubella syndrome were identified. A review of immunization coverage and surveillance data quality identified gaps. The combined annual rates of suspected measles and rubella cases (between 0.7 and 1.1 cases per 100000 population) and suspected congenital rubella syndrome cases (0.21 to 0.49 cases per 10000 live births) were below PAHOs thresholds. Also the frequent absence of immunization and travel histories within iPHIS was of concern (77.3% and 44.6% respectively).


These results support Ontarios sustained elimination status. However in order to satisfactorily meet PAHOs requirements for documenting the elimination of these diseases continued vigilance is required. Efforts are currently under way within Ontario to improve reporting.