Monitoring Rubella Immunity and Transmission in Central India Amidst Elimination Efforts

India along with other countries in the World Health Organization (WHO) Southeast Asia region has set a goal to eliminate rubella by December 2026 through active tracking and vaccination program. However, the incidence of sporadic events and outbreaks in recent years has posed a significant challenge to this goal. To access the ongoing infections and the effectiveness of immunization efforts, we evaluated the presence of anti-rubella IgM and IgG antibodies, which serve as indicators of ongoing infection and immune protection, respectively. Serum samples from individuals presenting with suspected rubella symptoms were collected and referred to the State Level Virus Research and Diagnostic Laboratory (SL-VRDL) at ICMR-NIRTH, Jabalpur between 1st May 2023 to 30th April 2024 for anti-rubella IgM and IgG analysis. Concurrently, samples from healthy pregnant women, attending Netaji Subhash Chandra Bose Medical College & Hospital, Jabalpur were obtained during the same period to assess the prevalence of maternal immunity against rubella. Collected samples were tested for rubella specific IgM and IgG antibody using ELISA. Rubella IgM seropositivity rate during the study period was 7.2% across all age groups, indicating ongoing transmission of rubella in central India. Rubella IgG seropositivity, reflecting immunity, was 81.0%, among all age groups, demonstrating a high level of immunity against the rubella virus in this region. Among pregnant women, rubella IgG seropositivity was 89.6%, suggesting that most pregnant women of reproductive age are having protection against rubella infection. The finding indicates that rubella elimination efforts are on the right track, and that the vaccination program is broadly effective. However, continuous detection of IgM positive cases, particularly in young children, highlights, immunity gaps, that may hinder timely elimination. These gaps could be due to logistical, cultural, and educational barriers and require further intensive efforts towards active immunization. Targeted and intensified immunization efforts are essential to achieve the elimination goal by 2026.