Lack of immunity against rubella among Italian young adults

Larocca Angela Maria Vittoria,Tafuri Silvio,Gallone Maria Filomena,Gallone Maria Serena,Germinario Cinzia

doi:10.1186/s12879-017-2295-y

Larocca Angela Maria Vittoria, Tafuri Silvio + Show 3 more

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https://doi.org/10.1186/s12879-017-2295-y

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Abstract

BackgroundTo support the evaluation of the 2010-15 National Plan for Measles and Congenital Rubella Elimination, the authors designed and performed a serosurveillance survey to verify the immunity/susceptibility rate against rubella among Apulian young adults.MethodsThe study was carried out from May 2011 to June 2012 in the Department of Transfusion Medicine/Blood Bank of Policlinico General Hospital in Bari. Subjects were enrolled by a convenience sampling. For each enrolled patient a 5 ml serum sample was collected and tested for anti-rubella IgG. The geometrical means (GMT) of anti-rubella IgG was calculated. T student test or ANOVA test, when appropriate, was used to compare the means of age per gender and GMT of anti-rubella IgG titres per age classes. Chi-square test was used to compare the proportion of anti-rubella IgG positive subjects per gender and per age classes. For all tests, a p value <0.05 was considered as significant.ResultsAt the end of the study 1764 subjects were enrolled, 1362 (77.2%) of which were male. The mean age was 38.4 ± 11.7 years (range: 17-65). 86.7% (95% CI = 85.0-88.2) had a positive titre of anti-rubella IgG. GMT of anti-rubella IgG titre was 4.3.The proportion of positive subjects was of 76.8% (n = 279/363; 95% CI = 72.2-81.1) in persons aged 18-26 years; 88.1% (n = 310/352; 95% CI = 84.2-91.3) in 27-35 year-old people; 88.5% (n = 464/524; 95% CI = 85.5-91.1) in 36-45 year-old people; 90.7% (n = 350/386; 95% CI = 87.3-93.4) among people aged 46-55 years and 90.6% (n = 126/139; 95% CI = 84.5-94.9) in 55-65 year-old people (Chi-square = 39.7; p < 0.0001). GMT of anti-rubella IgG titre was 4.3 (4.3 in male and 4.2 in female, t = 2.2; p = 0.03) and seems to differ dividing the enrolled subjects by age group (F = 14.3; p < 0.0001).ConclusionsAccording to our data, too many women of child-bearing age are still unprotected from rubella in the elimination era and in this scenario the public health efforts should be oriented to catch-up activities.

Highlights

To support the evaluation of the 2010-15 National Plan for Measles and Congenital Rubella Elimination, the authors designed and performed a serosurveillance survey to verify the immunity/susceptibility rate against rubella among Apulian young adults
The control of rubella is a global public health issue, because rubella virus infection during pregnancy may lead to fetal death or premature delivery, or may cause Congenital Rubella Syndrome (CRS), a condition which can involve all fetal organs, resulting in cataracts, deafness, heart defects, mental retardation
Our study showed a lack of immunity against rubella among Apulian young adults from 18 to 26 years of age; in this age group the proportion of susceptible subjects is more than 20%, in the other age groups the rate accounted 10-12%

Summary

Introduction

To support the evaluation of the 2010-15 National Plan for Measles and Congenital Rubella Elimination, the authors designed and performed a serosurveillance survey to verify the immunity/susceptibility rate against rubella among Apulian young adults. The control of rubella is a global public health issue, because rubella virus infection during pregnancy may lead to fetal death or premature delivery, or may cause Congenital Rubella Syndrome (CRS), a condition which can involve all fetal organs, resulting in cataracts, deafness, heart defects, mental retardation. A live-attenuated vaccine against rubella is available since 1960 [2] and in 2003 WHO reported that 131/215 countries/territories included rubella vaccine to their national immunization schedule. WHO European Region and within December 2012 all European countries introduced rubella-containing vaccines in their routine immunization programs; despite these public health efforts rubella is still circulating in Europe. Between 1990 and 2010, 467 cases of CRS were reported by 24 member states [7]

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