Top end rural and remote Indigenous women: an Australian population group vulnerable to rubella.
Australian efforts to prevent cases of congenital rubella syndrome have been largely successful, although concerns that eradication has not yet been achieved are ongoing. This paper describes an Australian population group with a vulnerability to rubella which has not previously been reported. Fewer than 75 per cent of Indigenous women from rural and remote communities who gave birth at Royal Darwin Hospital in 1999 and were tested for rubella antenatally had adequate levels of immunity. By comparison Indigenous and non-Indigenous women living in the Darwin urban area had a prevalence of adequate immunity to rubella on antenatal testing of > 90 per cent, similar to estimates for other Australian-born population groups. Action is required to reduce the risk of cases of congenital rubella syndrome occurring in rural and remote Indigenous communities in the Top End, and may be needed in rural and remote settings elsewhere in Australia. Ensuring each child, adolescent and young adult has received two doses of Measles Mumps Rubella vaccine as part of their primary immunization course will provide increased protection. In addition, more women lacking adequate rubella immunity need to be vaccinated postnatally than was found in this study. Providers of women's care would be assisted in this task if laboratories adopted a standardized approach to reporting the results of antenatal rubella serology tests.