Testing of rubella in suspected cases for measles:
Blood samples from all rubella suspected cases that are IgM negative for rubella should be tested for measles within 24 hours.
In the case of laboratory-confirmed rubella (or dengue) outbreaks, the total number of samples that are negative for either rubella (or dengue) might be overwhelming. In such a case, the surveillance team, in conjunction with the laboratory, should decide which samples to test for measles.
Investigation and reporting:
The reporting system must cover health facilities, private practitioners, hospitals and laboratories and have at least one reporting source for every geopolitical unit;
Written material should be provided to all health personnel describing their responsibilities and how to report cases, collect samples and send them for laboratory confirmation;
Investigation of all suspected cases should take place within 48 hours of rash onset. It should include:
Filling the case report form,
Investigation of contacts of the suspected case to determine if other cases have occurred,
Taking blood samples and samples for viral isolation (usually urine) from all sporadic cases and from 5-10 cases from each outbreak.
Weekly reporting of data, even in the absence of cases, is critical;
Timely feedback to all participants of the surveillance system, keeping them informed of where and when cases are occurring, is essential;
The reporting system must be monitored monthly using the surveillance indicators;
Cooperation from the private medical community by reporting suspected cases to the system is essential for all surveillance efforts.