Abstract
BackgroundRubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Most African countries including Liberia do not currently provide rubella-containing vaccine (RCV) in their immunization program. We analyzed the existing surveillance data to describe rubella cases and identify the at-risk population.MethodsWe conducted a retrospective descriptive statistics on the suspected-measles case-based surveillance data that obtained from the national database. Suspected-measles cases who were negative and indeterminate for measles IgM and tested for rubella IgM were extracted from the database. We used only rubella IgM positive cases to calculate trends and percentages by person, place and time. The cumulative-percent curve was used to visually describe the age distribution of rubella cases.ResultsDuring 2017–2018, a total of 2027 suspected-measles cases with known laboratory results were reported; of which, 1307 were tested for rubella IgM. Among tested cases, 472 (36%) were positive, 769 (59%) were negative and 66 (5%) were indeterminate for rubella IgM. Female contributed 269 (57%) of the confirmed rubella cases respectively. The median age was 7 years with an interquartile range of 5–10 years. From the total rubella cases, 6 (1%) were under 1 year, 109 (23%) were 1–4 years, 207 (44%) were 5–9 years, 87 (18%) were 10–14 years and 56 (12%) were more than or equal to 15 years. Women in their reproductive-age contributed 23 (5%) of rubella cases with 17% positivity rate. Two-thirds or 307 (65%) of the cases were reported from February to May which is dry season in Liberia.ConclusionsOur analysis revealed that rubella was widely circulating in Liberia. Majority of the cases were reported among children < 15 years. However, rubella was also reported among women of reproductive age and infants < 1 year with no report of congenital rubella syndrome (CRS). Detail investigation of rubella cases among infants of < 1 year and women of reproductive age is important to uncover CRS. Establishment of CRS surveillance and the introduction of RCV in the immunization program are crucial to prevent rubella infection and avert the risk of CRS.
Highlights
Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family
Rubella was reported among women of reproductive age and infants < 1 year with no report of congenital rubella syndrome (CRS)
Infection occurs a few weeks before conception and in early pregnancy especially during the first trimester may result in miscarriage, fetal death, or congenital deformities known as congenital rubella syndrome (CRS) [5, 6]
Summary
Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Rubella is an RNA virus belongs to Rubivirus genus within the Matonaviridae family [1]. The rubella virus is a human disease with no known animal reservoir and transmits to a healthy person through air droplet shed when an infected person sneezes or coughs [2]. Infection occurs a few weeks before conception and in early pregnancy especially during the first trimester may result in miscarriage, fetal death, or congenital deformities known as congenital rubella syndrome (CRS) [5, 6]. The likelihood of CRS is high, 90%, among infants born from mothers infected by rubella virus during their early pregnancy [7]. An infant with CRS or congenital rubella infection (CRI) sheds live rubella virus for a prolonged time [11]
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