{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:47:38Z","timestamp":1788587258943,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Osaka Prefectural Government"},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP26860453"],"award-info":[{"award-number":["JP26860453"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP18K17367"],"award-info":[{"award-number":["JP18K17367"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21K10432"],"award-info":[{"award-number":["JP21K10432"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP22fk0108628"],"award-info":[{"award-number":["JP22fk0108628"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the introduction of rubella-containing vaccine into routine immunization in 1977, rubella has not been eliminated in Japan. This study aimed to validate the immunization strategy and highlight crucial elements of the elimination program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We scrutinized cases of rubella and congenital rubella syndrome (CRS). Additionally, we analyzed the national vaccination coverage, seroprevalence, and number of maternal rubella-related spontaneous or artificial fetal deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The shift from selective to universal immunization significantly reduced rubella cases, coupled with increased seroprevalence in children. However, rubella resurged in 2012 to 2013 and 2018 to 2019, which was virologically and serologically confirmed to be associated with imported rubella virus and susceptible males. Although the disease burden of CRS may have been suppressed in the past by the large number of spontaneous or artificial fetal deaths, the incidence rate of CRS was comparable to that of the 1960s to 1980s. Cases of breakthrough infection and CRS were identified in females who were considered to have a history of single-dose vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Even with universal immunization, future epidemics and severe outcomes cannot be prevented unless immunization gaps are closed. Furthermore, CRS and breakthrough infection are not completely prevented by single-dose vaccination, indicating the need for second-dose vaccination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiae402","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:05:42Z","timestamp":1723640742000},"page":"440-450","source":"Crossref","is-referenced-by-count":7,"title":["How to Prevent Rubella Epidemics and Congenital Rubella Syndrome: Lessons From 42 Years of Longitudinal Epidemiology in Osaka Prefecture, Japan (1982\u20132023)"],"prefix":"10.1093","volume":"231","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9526-2411","authenticated-orcid":false,"given":"Daiki","family":"Kanbayashi","sequence":"first","affiliation":[{"name":"Division of Microbiology, Virology Section, Osaka Institute of Public Health , Osaka-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takako","family":"Kurata","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Virology Section, Osaka Institute of Public Health , Osaka-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kaida","sequence":"additional","affiliation":[{"name":"Laboratory Section, Fujiidera Public Health Center of Osaka Prefectural Government , Fujiidera-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Sakai City Institute of Public Health , Sakai-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumika","family":"Okayama","sequence":"additional","affiliation":[{"name":"Sakai City Institute of Public Health , Sakai-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Kase","sequence":"additional","affiliation":[{"name":"Department of Public Health, Osaka Metropolitan University Graduate School of Medicine , Osaka-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Komano","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infection Control, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University , Takatsuki-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Takahashi","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare , Otawara-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Ikuta","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Virology Section, Osaka Institute of Public Health , Osaka-shi"},{"name":"Research Institute for Microbial Diseases, Osaka University , Suita-shi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushi","family":"Motomura","sequence":"additional","affiliation":[{"name":"Division of Public Health, Osaka Institute of Public Health , Osaka-shi ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"2025022016334028400_jiae402-B1","first-page":"970","volume-title":"Vaccine","author":"Reef","year":"2018","edition":"7th ed"},{"key":"2025022016334028400_jiae402-B2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.15585\/mmwr.mm7106a2","article-title":"Progress toward rubella and congenital rubella syndrome control and elimination\u2014worldwide, 2012\u20132020","volume":"71","author":"Zimmerman","year":"2022","journal-title":"MMWR Morb Mortal Wkly 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