Rubella Immunity among Italian Female Healthcare Workers: A Serological Study.

Luca Coppeta,Ilaria Iannuzzi,Iacopo D’Alessandro,Cristiana Ferrari,Antonio Pietroiusti,Ottavia Balbi,Marco Trabucco Aurilio

doi:10.3390/ijerph17217992

Abstract

Rubella, also known as German measles or three-day measles, is an infectious disease caused by virus of the genus Rubivirus, which may be prevented by vaccination. The infection is potentially dangerous for non immune subjects, although 20–50% of infected subjects are asymptomatic. Healthcare workers (HCWs) have an increased potential exposure to rubella in comparison to the general population, putting them and their patients at risk of infection and its complications. In 2019, 20 cases of rubella have been reported in Italy. According to the Italian National Immunization and Prevention Plan, HCWs should provide a written certification of vaccination for rubella or serological evidence of protective antibodies. The aim of the study was to evaluate the rubella immunization status in female HCWs of the teaching hospital Policlinic Rome Tor Vergata (PTV) of childbearing age. For this purpose, we retrospectively checked the serologic values of rubella-specific IgG antibodies analyzing the clinical records of the HCWs of undergoing the occupational health surveillance program from January 1st to June1st 2020. Five hundred fourteen HCWs with a mean age of 23.19 (range 19–37, DS: 2.80) were included: 90.3% (464) showed a protective antibody titre. The mean value of the anti-rubella IgG was 49.59 IU/mL. Our study shows a non-protective anti rubella IgG titre in a substantial percentage of HCWs (9.7%). As vaccine protection decreases over the years and the risk of congenital rubella syndrome (CRS) in vaccinated subjects should not be underestimated, we suggest routine screening of the immunological status followed by the administration of a third dose of vaccine if the antibody titre becomes non-protective.

Highlights

Rubella is a vaccine-preventable disease caused by virus of the genus Rubivirus
Using ModuLab, the software adopted by the Chemical Analytical Laboratory of Policlinic Rome Tor Vergata (PTV), we reported all values of rubella-specific IgG antibodies in a Microsoft Excel worksheet
In PTV, the evaluation of the immunization against rubella is performed by means of the LIAISON® Rubella IgG assay using chemiluminescence immunoassay (CLIA) technology: in this way a semi-quantitative evaluation of specific IgG antibodies to rubella virus in human serum or plasma samples is obtained. 590 subjects were potentially eligible for the study

Summary

Introduction

Rubella is a vaccine-preventable disease caused by virus of the genus Rubivirus. Known as German measles or three-day measles, it is characterized by a rash that begins on the face and spreads to the rest of the body. 20–50% of infected subjects are asymptomatic the infection is potentially dangerous for non-immune subjects. Typical signs and symptoms are low-grade fever, headache, general discomfort, cough, pink eye, enlarged lymph nodes, muscle pain, runny or stuffy nose [1]. Infection acquired during pregnancy can cause the congenital rubella syndrome (CRS) with a clinical spectrum spanning from birth defects, to abortion or premature birth, to deafness [2,3]. It is estimated that almost 100,000 children with CRS were born each year [4]

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