Abstract
BackgroundWhen contracted in pregnancy, rubella may cause serious chronic infection of the fetus and development of Congenital Rubella Syndrome. Despite widespread application of rubella vaccination, periodical outbreaks are still being reported worldwide. The aim of this study was to determine rubella seroprevalence and antibody levels in neonates in Serbia as a proxy of maternal serostatus.MethodsELISA based serological testing for rubella was done in 599 neonates treated at the Institute of Neonatology in Belgrade, from January 2010 to December 2011. All individuals with rubella IgG concentration ≥10 IU/ml were considered seropositive for rubella.ResultsThe mean age of enrolled neonates was 18 ± 6 days. The overall seroprevalence of rubella IgG antibodies among the tested neonates was 540/599(90.2 %, 95 % CI: 87.5–92.3). Seropositivity rate among sera of the neonates enrolled in 2010 was significantly higher than those collected in 2011 (p < 0.0001). There was no difference in average maternal age, gestational age or frequency of receiving blood products among the two study years. Significant high seropositivity rate was observed among neonates from mother aged >30 as compared to those from mothers aged <20 years (p = 0.02). Significant difference was also found between average IgG titers in the two study years (79 IU/mL in 2010 vs. 46 IU/mL in 2011, p < 0.0001).ConclusionWe report on high rubella seroprevalence among newborns in Serbia, as a proxy of rubella serostatus of childbearing aged women. Notably, declining trend of rubella antibodies toward diminishing titers suggest the importance of sustained rubella serosurvey and antenatal screening at the national level.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3514-y) contains supplementary material, which is available to authorized users.
Highlights
When contracted in pregnancy, rubella may cause serious chronic infection of the fetus and development of Congenital Rubella Syndrome
Serological testing for rubella was done within blood screening for TORCH agents (Toxoplasma gondii, Rubella virus, Cytomegalovirus, Herpes simplex virus) of neonates treated at the Institute of Neonatology in Belgrade, from January 2010 to December 2011
Serological testing revealed that 540/599 tested neonates were positive for IgG antibodies to rubella, corresponding to the overall seropositivity rate of 90.2 % (Table 1)
Summary
Rubella may cause serious chronic infection of the fetus and development of Congenital Rubella Syndrome. According to the official Serbian Ministry of Health reported data compiled by WHO and UNICEF, in the initial years of MMR vaccine introduction in Serbia, 1994 and 1995, immunization coverage was 81 and 86 %, respectively. For the two study years, 2010/2011, measles and rubella first dose coverage of 95 and 93 %, respectively, has been reported, more recently a decline below 90 % has been noted again [6]. Rubella and CRS reporting have been mandatory even before vaccine introduction epidemiological data are incomplete and discrepant, whereas surveillance data are limited, in many cases with no laboratory confirmation [8]. Based on the WHO data, the number of reported rubella cases in Serbia in the last decade is gradually declining. In spite of solid MMR uptake, in the view of changing vaccination strategies and possible gaps in surveillance it is important to assess rubella serostatus among target groups such as pregnant women
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