Abstract

The National Plan for the Elimination of Rubella was implemented in Spain in 2008 using the logistics of the National Plan for the Elimination of Measles that have been employed since year 2000. Molecular characterization of rubella virus (RUBV) is important for disease surveillance and for monitoring elimination of the disease throughout the world. We describe the first complete series of data regarding the circulation of RUBV genotypes in Spain. The 739-nucleotide fragment designated by the WHO for RUBV genotyping was sequenced in 88 selected cases collected from 1998 to 2014. Five genotypes were identified: 1E, 2B, 1J, 1I, and 1a. Genotype 1E was predominant between 1998 and 2003 but was replaced by genotype 2B, which was detected in sporadic cases in 2004, 2006, 2008, 2012, 2013 and 2014. There was an outbreak of genotype 2B in Algeciras (Andalusia) in 2008. Genotype 1J caused an outbreak in Madrid in 2004/2005 and sporadic cases in 2005 and 2007. Genotype 1I was found to have infected an immune-suppressed patient with neurological symptoms in 2008. Finally, vaccine strain RA 27/3 was detected in three sporadic cases, two of them immune-suppressed and without a recent history of vaccination. This suggests that during these years there were a series of imported sporadic cases and outbreaks, confirming the findings of epidemiological data analysis. The importation sources were generally consistent with our geographic and cultural ties, mainly with Europe (genotypes 1E, 2B, 1I) and Latin America (1J).

Highlights

  • We describe the rubella virus (RUBV) genotypes detected in Spain over a period of 17 years, between 1998 and 2014, with the aim of establishing the pattern of virus circulation and testing the hypothesis of the interruption of endemic circulation suggested by the incidence data

  • Specimens were collected at origin and processed in the National Center of Microbiology in accordance with WHO recommendations [17]

  • Isolation was performed as previously described [13, 18] in Vero and Vero E6 cells

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Summary

Materials and Methods

Eighty-eight clinical samples (nine of urine, eight of serum, three of blood, two of saliva, two of cerebrospinal fluid [CSF], one isolate and 63 pharyngeal exudates) from 88 confirmed rubella cases collected from 1998 to 2014 in several regions of Spain were studied (Tables 1 and 2)

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