Rubella IgM Research Articles

Recent rubella infection among childbearing women in a tertiary hospital in Nigeria: A seroepidemiological indication for vaccination need

Background : Congenital Rubella Infection can be prevented and future generation saved from disability by protecting women of reproductive age through vaccination. The study is aimed at determining serological evidence of recent rubella infection among women of childbearing age. Method : A cross sectional study was carried out among 285 women aged between 15 and 49 years. Enzyme immunoassay method was used to detect and quantify human IgM and IgG antibodies with avidity for Rubella virus in sera of participants. Socio-demographic characteristics of the subjects, along with recent history of fever, rash and adverse pregnancy outcome among others were obtained using a questionnaire. Statistical analysis was carried out using the program statistical package for social sciences (SPSS) version 16. Majority (78.3%) of the women recruited for the study were within 15-34 years age range. Of the 285 sera assayed for Rubella IgM antibodies, 23 (8.1%; 95% CI: 4.9%-11.3 %.) was IgM seropositive, while the remaining 262 (91.9%) were seronegative. A total of 7 (2.5%) of reproductive age women in Ilorin had a recent primary infection while 16 (5.6%) had a persistent Rubella infection or recent re-infection. In conclusion, there is need for vaccination of susceptible women of reproductive age in Ilorin as a large number of women have Rubella in their reproductive age. Keywords : Rubella, Immunoglobulin M, avidity, reproductive age, Ilorin, Nigeria

Genotypes of rubella virus and the epidemiology of rubella infections in the Democratic Republic of the Congo, 2004-2013.

Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc.

Laboratory confirmation of rubella infection in suspected measles cases.

As a part of measles outbreak based surveillance undertaken by the World Health Organization India, suspected measles cases were referred for the laboratory diagnosis at National Institute of Virology (NIV) Pune and NIV Unit Bengaluru. Altogether, 4,592 serum samples were referred during 2010-2015 from the States of Karnataka (n = 1,173), Kerala (n = 559), and Maharashtra (n = 2,860). Initially, serum samples were tested in measles IgM antibody EIA and samples with measles negative and equivocal results (n = 1,954) were subjected to rubella IgM antibody detection. Overall, 62.9% (2,889/4,592) samples were laboratory confirmed measles, 27.7% (542/1,954) were laboratory confirmed rubella and remaining 25.2% (1,161/4,592) were negative for measles and rubella. The measles vaccination status was available for 1,206 cases. Among the vaccinated individuals, 50.7% (612/1,206) were laboratory confirmed measles. The contribution of laboratory confirmed measles was 493 (40.8%) from Maharashtra, 90 (7.5%) from Karnataka, and 29 (2.4%) from Kerala. Since, 1/3rd of suspected measles cases were laboratory confirmed rubella, an urgent attention needed to build rubella surveillance in India. Additional efforts are required to rule out other exanthematous disease including Dengue and Chikungunya in measles and rubella negatives. J. Med. Virol. 88:1685-1689, 2016. © 2016 Wiley Periodicals, Inc.

Hidden varicella outbreak, Luang Prabang Province, the Lao People's Democratic Republic, December 2014 to January 2015.

In January 2015, the Lao People's Democratic Republic Ministry of Health received a report of 34 cases of fever and rash with one laboratory-confirmed measles case in Houitone village, Pakseng District of Luang Prabang Province. Between 21 and 27 January, we conducted a field investigation to determine the etiology, magnitude and severity of this outbreak. We conducted active case findings in Houitone and neighbouring villages and collected information on age, location, date of rash onset, symptoms and measles vaccination status. We collected serum samples from cases with rash onset of less than 28 days and tested for measles and rubella IgM using enzyme-linked immunosorbent assay. Between 22 December 2014 and 23 January 2015, 190 fever and rash cases were identified in seven villages in Pakseng District with the majority of the cases in Houitone village. The most affected age group was between 1 and 9years. The majority of the rashes were vesicular. Of the additional 43 serum samples collected, no samples tested positive for measles or rubella IgM. The clinical manifestation and epidemiology of the disease suggested a varicella outbreak. The rapid response to a single laboratory-confirmed measles case did not identify a measles outbreak but suggested a varicella outbreak. Low measles vaccination coverage led us to recommend a routine catch-up vaccination campaign. We also recommend collecting information of rash types and photos of rashes in future fever and rash outbreaks to better differentiate potential etiologies.

Cytomegalovirus, Parvovirus B19 and Rubella Co-Infection among Pregnant Women Attending Antenatal Clinics in Mwanza City: The Need to be considered in Tanzanian Antenatal Care Package

Background: Viral infections are common in pregnancy and have been associated with poor pregnancy outcome. In many developing countries including Tanzania, the magnitude of these infections and their impact to pregnancy outcome is not clearly understood. The aim of this study was to determine the magnitude of these infections. The information from this study may influence policy makers to consider routine screening of these infections during antenatal visits. Methods: A cross sectional hospital based study involving 214 pregnant women was conducted between December 2014 to and August 2015 in two antenatal clinics in Mwanza city. Rubella, cytomegalovirus and parvovirus B19 (B19) specific IgG and IgM antibodies were detected by using commercial indirect enzyme linked immunosorbent assay. Data were analyzed using STATA version 11. Results: The median age of enrolled pregnant women was 21 (Interquartile range: 20-26) years. Previous co-infections of rubella, cytomegalovirus and B19 was detected in 78 (36.5%) of pregnant women tested. A total of 20 (9.4%) pregnant women had acute co-infection of rubella and parvovirus B19 while 1(0.5%) had acute co-infection of cytomegalovirus and parvovirus B19. The odds of having previous co-infection (IgG sero-positivity) increase significantly as the age increases (odd ratio: 1.056, 95% CI: 1.00-1.11, P=0.03). Moreover, as the gestation age increases the odds of having co-infection decreases significantly (odd ratio: 0.923, 95% CI: 0.88-0.96, P=0.001). Conclusion: Considerable proportion of pregnant women in Mwanza is co-infected with rubella, Cytomegalovirus and parvovirus B19. We recommend routine screening for these infections during antenatal visits so as to reduce the possibility of congenital infection.

Incidence of rubella in a state in North-western Nigeria: a call for action.

IntroductionRubella cases are often under-reported, especially in many developing countries, owing to inadequate attention and weak funding of elimination strategies, despite being an epidemic-prone disease. Based on available data, this paper, therefore, seeks to bring the attention of public health practitioners, researchers and policy makers to threats of rubella in our environment, and also recommend measures to mitigate the threats.MethodsThe authors conducted a retrospective cross-sectional study in which the laboratory results of febrile-rash-illness cases in Kebbi State, Northwest Nigeria, from January 1, 2014 to December 31, 2015 were analysed, using descriptive statistics and chi-square test. We obtained the data set through the routine Integrated Disease Surveillance System and Response being conducted in Nigeria.ResultsA total of 413 febrile-rash-illness cases were reported and investigated in Kebbi State from 2014 to 2015, 5 (3.5%) tested positive for rubella IgM in 2014 while 7(2.6%) tested positive in 2015. There was no statistically significant difference in the incidence of rubella between 2014 and 2015 (p> 0.05). Rubella infection was mainly found in children less than 5 years of age with peak incidence period during the hot season (between February and April). There was no significant sex bias in this study. However, our practice experiences in this environment suggest a systematic under-reporting and under-diagnosis of febrile- rash-illnesses.ConclusionThere was no statistically significant difference in the incidence of rubella in children in our setting for the 2-years studied. However, there is a potential for increase in the transmission of the disease due to non-availability of routine childhood vaccination against rubella and the systematic under-reporting of suspected cases and weak laboratory support. In order to better appreciate the burden of rubella infection, there may be a need to undertake a prevalence survey, and simultaneously, strengthening case-based surveillance in Northwestern Nigeria. Further, WHO should support national government in accelerating the introduction of rubella-containing vaccine to stem the potential spread of this infectious disease.

Measles & rubella outbreaks in Maharashtra State, India.

Background & objectives:Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping.Methods:Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells.Results:Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated.Interpretation & conclusions:Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State.

Tourch Infections in Mothers with Bod as a Cause of Neonatal Miscarriages and Fetal Malformation in Duhok Province, Kurdistan Region/ Iraq

This study was performed to demonstrate the effect of TORCH agents on pregnancy outcome of 84 mothers with BOD, the number of single, twice, triple, four and more miscarriages were 102 (55.4%), 50 (27.2%), 27 (14.7%) and 5 (2.7%), respectively. Out of 102 BOH pregnant women with single miscarriage, 43 (42.2%) and 2 (4.9%) were seropositive for anti T. gondii IgG and IgM, respectively, 89 (87.3%) and 17 (16.7) were seropositive for anti CMV IgG and IgM, respectively, 63 (61.8%) and 3 (2.9%) were seropositive for anti Rubella IgG and IgM, respectively and 63(61.8%) and 14(13.7) were seropositive for HSV-2 IgG and IgM, respectively. Regarding women with twice miscarriage, 1 (2.0%), 14 (28.0%) were seropositive for T. gondii anti IgG and IgM, respectively, 16 (8.0%), 43 (86.0%) were seropositive for CMV anti IgG and IgM, 29(58.0%), respectively. The IgG of anti Rubella was recorded in 29 (58.0%) no any case for anti IgM. and 29 (58%) and 3 (6.0%) were positive for HSV-2 anti IgG and IgM, respectively. The number of cases with triple miscarriages, 8 (11.1%) were seropositive for anti T. gondii IgG antibodies, while no any case was found against IgM antibodies. Only, 3 (4.2%), 22 (30.6%) were seropositive for anti CMV IgG and IgM respectively. The seropositivity of anti Rubella, anti HSV-2 IgG and IgM antibodies in group with triple miscarriages were recorded in 12 (16.7%), 10 (13.9%), 0 (0.0%) and 3 (4.2%) respectively. The number of cases with four and more miscarriages, all (100%) were seropositive for CMV anti IgG and IgM, and one (20%) for T. gondii anti IgG and IgM, while 2 (40%) and 4 (80%),were seropositive for anti Rubella and anti HSV-2 IgG, respectively. Also the results indicated that 134 (72.8%) of all examined pregnant women with BOH have history of miscarriages,14 (7.6%) congenital malformation, 13 (7.1%) intrauterine growth retardation,10 (5.4%) premature labor and 13 (7.1%) still birth. with the predominant of anti CMV IgG and IgM antibodies.

Serological and Molecular Diagnosis of Rubella virus and Cytomegalovirus in aborted Patients in Al-Najaf province

Background: Viral infections such as Rubella and Cytomegalovirus are feared risk during pregnancy. Rubella and Cytomegalovirus virus are fairly the respective major diagnostic issues in pregnancy, the laboratory diagnosis, and its rational use in combination with clinical information are presented, also the value of passive prophylaxis, therapy, and prenatal diagnosis as well as the possible management for diminishing the infection problems in pregnancy. Aims of study: The study was aimed to evaluate the ELISA result for rubella and cytomegalovirus (CMV) IgM and IgG and compare the results of the ELISA with RT-PCR to arbitrate discordant results. Methodology: The present study was carried out on 57 pregnant women, all of them had bad obstetric history (BOH). Patients were between 15-40 years old, and they were attending Al- Zahra Teaching Hospital during the period of May 2012 till May 2013. Serological evaluation for Rubella Cytomegalovirus infections were carried out by using IgM and IgG Enzyme Linked Immunosorbent Assay (ELISA ) method and molecular technique (Real Time - PCR). Results :The results showed 12 patients (21.1%) were Seropositive for Rubella virus IgM, and 46 ( 80.7%) were Seropositive for Rubella virus IgG, while only 24 (42.1%) were Seropositive for both IgG and IgM at same time. In this study 2 patients ( 7.69 %) were Seropositive for both Rubella IgM and Cytomegalovirus together and 12 ( 30 %) were Seropositive for both Rubella IgG and Cytomegalovirus IgG. Regarding to Rubella infection ,the results showed that 12 (21.1%) were seropositive for Rubella IgM and 26 (45.6 %) were seropositive for Rubella IgG , while only 6 (17.5%) were seropositive for both IgM and IgG. The Real Time PCR results showed only 6( 10.5% ) were positive for Rubella virus and 3 (5.26 %) were positive for Cytomegalovirus . Conclusion: The accurate diagnosis of Rubella and Cytomegalovirus infection should be done by molecular method and not based on ELISA test which should be used as screening test . Recommendations :Advice the gynecologist to take care before give management for pregnant women thatpresent with more than one infection at same time unless confirm the diagnosis by more than one technique likeRT-PCR .

Acute rubella infections mimicking measles in children in Calabar, Nigeria

The clinical diagnosis of rubella is unreliable as the symptoms are often confused with other viral and non-viral exanthematic illnesses. Acquired forms are self-limiting whereas the congenital type has devastating consequences on the foetus. The aim of this study is to highlight rubella infections in children and to draw to the attention of relevant authorities the need for routine rubella immunization for children and women of childbearing ages. This was a prospective cross-sectional study conducted from February to December 2012. Thirty five children aged 2 to 18 years, were referred to selected health facilities in Calabar following reports of symptoms of fever and skin rash, clinically resembling measles. The demographic data of the children were obtained. Blood was collected from each child and sent for measles and rubella IgM ELISA. Data were analysed using SPSS version 16. Of the 35 children with fever and skin rash, 22 were males while 13 were females (1.7:1). Fourteen (40%) of the children were found to be IgM seropositive for rubella. Five (35.7%) of rubella IgM seropositive children were less than five years of age while 7 (50%) were 5-10 years old. There was no significant difference in the seropositivity for rubella IgM antibody according to age and sex of the patients and (P = 12.5). Only one child (2.8%) was positive for measles IgM. Acute rubella infection is clinically indistinguishable from measles and is confirmed to be present in Calabar, Nigeria. We therefore advocate for routine immunisation of children and women of childbearing ages to prevent the damaging effects of rubella to the unborn baby.

Rubella outbreak in a Rural Kenyan District, 2014: documenting the need for routine rubella immunization in Kenya.

BackgroundRubella infection has been identified as a leading cause of birth defects commonly known as Congenital Rubella Syndrome (CRS). Kenya does not currently have a rubella immunization program nor a CRS surveillance system. In 2014, a rubella outbreak was reported in a rural district in Kenya. We investigated the outbreak to determine its magnitude and describe the outbreak in time, place and person. We also analyzed the laboratory-confirmed rubella cases from 2010 to 2014 to understand the burden of the disease in the country.MethodsThe Rubella outbreak was detected using the case-based measles surveillance system. A suspected case was a person with generalized rash and fever while a confirmed case was a person who tested positive for rubella IgM. All laboratory-confirmed and epidemiologically linked cases were line listed. The measles case-based surveillance database was used to identify rubella cases from 2010 to 2014.ResultsA total of 125 rubella cases were line listed. Fifty four percent of cases were female. Case age ranged from 3 months to 32 years with a median of 4 years. Fifty-one percent were aged less than 5 years, while 82 % were aged less than 10 years. Six percent of the cases were women of reproductive age. All cases were treated as outpatients and there were no deaths. The number of confirmed rubella cases was 473 in 2010, 604 in 2011, 300 in 2012, 336 in 2013 and 646 in 2014.ConclusionsAnalysis of Kenya rubella data shows that rubella is endemic throughout the country, and many outbreaks may be underestimated or undocumented. Six percent of all the cases in this outbreak were women of reproductive age indicating that the threat of CRS is real. The country should consider initiating a CRS surveillance system to quantify the burden with the goal of introducing rubella vaccine in the future.

Seroprevalence of Rubella Viral Infection in Women of Childbearing Age in Lokoja, Nigeria

The study aims to investigate the prevalence of Rubella IgG and IgM with reference to parity status among women of childbearing age attending Federal Medical Center, Lokoja Nigeria. Socio-demographic data were obtained using structured questionnaire before blood sample collection from the subjects. Rubella screening was done using IgG captured ELISA kits. IgG positive samples were further screened for IgM ascertain current or past infection. Of the 240 evaluated serum samples, 231 (96.25%) were positive, 3 (1.25%) had borderline and 6 (2.5%) were negative to Rub-IgG. Rub-IgM assays revealed 4(1.7%) positivity. Most of the subjects had acquired immunity before age 30. 202(91.0%) of 210(94.6%) monogamous and all recorded subjects with polygamous were positive to rubella IgG (p=0.789) while 3(1.4%) and 1(0.5%) respectively had positive result for rubella IgM (p=0.224). 186(83.6%) of 193(86.9%) and 27(12.2%) of 29(13.1%) within the parous and nulliparous group were positive to Rub-IgG (p=0.266) 4(1.9%) positive and all the subjects under nulliparous group had no current infection (p=0.694). In addition to other risk factors, parity also plays a role in exposure to the virus because it increases frequency of contact with the environment and although immunity is high among the subjects. It is therefore imperative to advocate for Rubella vaccination to avoid near miss or near death experience of the fetus.

MOLECULAR DETECTION OF RUBELLA VIRUS GLYCOPROTEIN AMONG WOMEN OF CHILDBEARING AGE IN LOKOJA

Abstract Background: The gene order for the Rubella virus (RV)40S RNA is 5' -p150-p90-C-E2-E1-3' and the complete nucleotide sequence of RV has been determined for three strains. The RV core is surrounded by a host-derived lipid bilayer containing 5-6nm long spikes composed of the E2 and E1 glycoproteins Objective(s): Molecular detection of Rubella virus glycoprotein after serum screening of 240 women attending Federal Medical Centre Lokoja (FMC) via IgG and IgM ELISA. Method: Cross-sectional study was carried out in Obstetrics and Gynecology clinic at FMC Lokoja. Serology for anti RV-IgG and IgM was done for 240 blood samples after serum separation. Polymerase Chain Reaction (PCR) was done for rubella cDNA via RUB 2 & 7 and RUB 8 & 11 specific primers and this was sequenced using dye terminator cycle sequencing. Result: 231(96.25%) of 240 and 4(1.7%) of 231 subjects were positive to Rubella IgG and IgM respectively after assay. PCR band result had 320bp on 1kb DNA plus ladder of 0.9μg/lane and live blast of the 320 length sequence result revealed a Rubella membrane glycoprotein E1 (Rubella_E1). All subjects that had blood transfusion were positive to Rub-IgG (p=0.566) while 3(1.6%) of 168(88.9%) respondents with no blood transfusion were IgM positive (P= 0.537). 61(32.6%) of 67(35.8%) respondent who reported history of rash were positive to Rub-IgG (p=0.057) and of 30(22.7%) that has had a miscarriage, 29(22.0%) was positive to Rub-IgG (p=0.731) Conclusion: Rubella virus membrane glycoprotein E1, an important structural type 1 membrane protein in the entire pathogenesis of rubella virus has been confirmed in this locality.

The etiology of Rubella IgM positivity in patients with rubella-like illness in Iran from 2011 to 2013.

Rubella is a mild self-limiting contagious viral disease caused by the rubella virus (RV). Although symptoms are often mild, the concern is centralized around the possible effect on a fetus growth and development in case of primary infection during early months of pregnancy. Recently acquired rubella is commonly confirmed by RV-specific IgM antibody detection in the serum. However, rubella primary infection is not always the only cause of IgM positivity. Other possible causes of rubella IgM positivity may include IgM persistence following vaccination or naturally acquired infection or even re-infection. Moreover, nonspecific IgM reactivity can cause false-positive results. There are few articles to differentiate the aetiology of rash in rubella-like illnesses. However, limited studies have been conducted on clarifying the source of IgM positivity in these cases. This article reports the study of 10,896 clinical cases demonstrating rubella-like illness between 2011 and 2013 in Iran. The rate of IgM positivity among these cases was 0.52% (57 cases). As predicted based on the high coverage of vaccination in Iran fewer than 16% of cases with ELISA IgM positive result, were due to current rubella primary infections. The greater part of the positive IgM reactions occurred in cross reactivity with other viruses (31.6%) or in prolonged IgM response post vaccination (24.6%). This research confirmed that the positive result of rubella IgM assay in vaccinated individuals is mainly caused by prolonged IgM production, rubella re-infection, and false positivity due to infection with other viruses, rather than the rubella primary infection itself.

Trends of rubella incidence during a 5-year period of case based surveillance in Zimbabwe.

BackgroundRubella is a disease of public health significance owing to its adverse effects during pregnancy and on pregnancy outcomes. Women who contract rubella virus during pregnancy may experience complications such as foetal death or give birth to babies born with congenital rubella syndrome. Vaccination against rubella is the most effective and economical approach to control the disease, and to avoid the long term effects and high costs of care for children with congenital rubella syndrome as well as to prevent death from complications. Zimbabwe commenced rubella surveillance in 1999, despite lacking a rubella vaccine in the national Expanded Programme on Immunization, as per the World Health Organization recommendation to establish a surveillance system to estimate the disease burden before introduction of a rubella vaccine. The purpose of this analysis is to describe the disease trends and population demographics of rubella cases that were identified through the Zimbabwe national measles and rubella case-based surveillance system during a 5-year period between 2007 and 2011.MethodsData from the Zimbabwe National Measles Laboratory for the 5-year study period were analysed for age, sex, district of origin, seasonality, and rubella IgM serostatus.ResultsA total of 3428 serum samples from cases of suspected measles in all administrative districts of the country were received by the laboratory during this period. Cases included 51% males and 49% females. Of these, 2999 were tested for measles IgM of which 697 (23.2%) were positive. Of the 2302 measles IgM-negative samples, 865 (37.6%) were rubella IgM-positive. Ninety-eight percent of confirmed rubella cases were children younger than 15 years of age. Most infections occurred during the dry season.ConclusionsThe national case-based surveillance revealed the disease burden and trends of rubella in Zimbabwe. These data add to the evidence for introducing rubella-containing vaccine into the national immunization programme.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1642-4) contains supplementary material, which is available to authorized users.

Epidemiological Evaluation of Rubella Virus Infection among Pregnant Women in Ibadan, Nigeria

Rubella is a vaccine-preventable, mild rash-inducing viral disease with complications that include a spectrum of birth defects in the developing fetus, especially if the infection is acquired in the early months of pregnancy. Consequently, the primary objective of global rubella control programs is prevention of congenital rubella infection and associated birth defects. Despite the availability of safe and effective vaccines, and the elimination of the rubella virus in many developed countries, substantial commitment to rubella control has not been demonstrated in developing countries. This study appraises immunity to rubella, and consequently makes appropriate recommendations aimed at facilitating effective control. A cross-sectional sero-surveillance study was carried out among defined 272 consenting ante-natal clinic attendees in south-western, Nigeria. Prevalence rates of 91.54% and 1.84% were recorded for the anti–rubella virus (anti-RV) IgG and IgM, respectively. Also, 90.7% and 92.3% of the women aged ≤30 years and >30 years, respectively, had detectable anti-RV IgG. No significant association (p = 0.94) was recorded between anti-RV IgG detection and age of the women. Previous exposure and susceptibility of significant fraction of the population to rubella infection were confirmed. Considerable political commitment and promotion of free rubella immunization specifically for women with childbearing potential were recommended.

The study of congenital cytomegalovirus, Rubella and Herpes Simplex Virus-2 infections in infants

AimsThe study was conducted to analyze the role of Cytomegalovirus (CMV), Rubella and Herpes Simplex Virus (HSV-2) as an etiological agent in congenital infections in infants. Material and methodsThe study was carried out at National Reference Centre i.e. NCDC, Delhi where samples are referred from various government hospitals of Delhi from the period of January 2013–December 2013. The samples were tested for CMV, Rubella and HSV specific IgM antibodies by μ capture ELISA (Enzyme linked Immunoassay). ResultsIn children the overall positivity of CMV, Rubella and HSV-specific IgM antibodies was 20.7%, 5.4%, and 2.3% respectively. ConclusionThe study indicated that maternal infection with CMV, Rubella and HSV-2 is a major contributory factor for congenital infections in neonates and infants and therefore screening for these viruses in early pregnancy should be made mandatory.

Seroprevalence rates of Toxoplasma gondii, rubella, cytomegalovirus, syphilis, and hepatitis B, seroprevalences rate in the pregnant population in İstanbul

We retrospectively evaluated the rate of Toxoplasma gondii, rubella, syphilis, cytomegalovirus, and hepatitis B in Istanbul to compare these results with those of other literature and to contribute to the national screening program. The study was conducted in 2011 with women in the first trimester of pregnancy, with ages ranging between 16 and 48 years, in Bakırköy Training and Research Hospital's outpatient pregnancy clinic between January 2008 and January 2013. The mean age of pregnant women was 28.12±5.53, and the mean gravidity was 1.76+0.84.The seropositivities of T. gondii IgM and IgG, cytomegalovirus IgM and IgG, rubella IgM and IgG, VDRL (syphilis), HbsAg, anti-HBsAg were evaluated by ELISA method and evaluated in relation with age and parity. The seropositivity rates were as follows: T. gondii IgM: 0.8%, T. gondii IgG: 31.4%, cytomegalovirus IgM: 0.8%, cytomegalovirus IgG: 99.3%, rubella IgM: 0.2%, rubella IgG: 95.7%, VDRL: 0%, HbsAg: 1.2%, and anti-HbsAg: 26.3%. Also, pregnant women with T. gondii IgG(+) were older than pregnant women with T. gondii IgG(-), and this was statistically significant (p<0.005). Pregnant women with anti-HbsAg(+) were older than pregnant women with anti-HbsAg IgG(-), and this was statistically significant (p<0.005). Also, pregnant women with anti-HbsAg(+) had higher gravidity rates than pregnant women with anti-HbsAg(-), and this was statistically significant (p<0.005). To protect from perinatally transmitted diseases, vaccination programs against rubella and hepatitis B should be extended, and educational programs including the whole country should be arranged. Screening of high-risk pregnant women will be more appropriate when considering the financial charges of screening programs performed for early detection of perinatal infections and for protecting the fetus.

Seroprevalence of TORCH infections in antenatal and HIV positive patient populations

BackgroundThe TORCH (Toxoplasma gondii, Rubella, Cytomegalovirus (CMV) and the Herpes Simplex Virus) cause range of diseases in pregnant women and HIV patients and lead to adverse fetal outcomes when not treated on time, in HIV positive can cause life threating infections. There is inadequate data available of these infections in India. MethodsA retrospective study was undertaken to determine the seroprevalence of the TORCH infections in antenatal and HIV/AIDS patients at a tertiary care centre. The laboratory data pertaining to the period Jan 2012–May 2014 was analyzed. The study population involved 162 antenatal cases and 729 HIV/AIDS patients under review at an ART centre. Laboratory testing was done for the presence of IgM and IgG antibodies against the TORCH infections by ELISA method. ResultsAmong the antenatal cases, 30 (18.52%) samples were found to be seropositive for Toxoplasma IgM, CMV IgM antibodies were found in 47 (29.01%) samples, HSV IgM antibodies were found in 12 (7.40%) samples, Rubella IgM antibodies were found in 13 (8.02%) samples, indicating recent infection. Among the HIV/AIDS cases, indicative of recent or current infection, 160 (21.94%) samples were positive for Toxoplasma IgM, CMV IgM was found in 99 (13.58%), HSV IgM antibodies were found in 98 (13.44%) and Rubella IgM in 47 (6.44%). ConclusionsThe study showed a high seroprevalence of the infections caused by the TORCH complex amongst pregnant women and HIV/AIDS patients despite improved hygiene conditions and health awareness. Maximum seroprevalence for CMV was observed followed by Rubella and HSV infection.

Surveillance of congenital rubella syndrome (CRS) in tertiary care hospitals in Hanoi, Vietnam during a rubella epidemic

ObjectiveTo describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam. MethodsProspective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study. ResultsDuring the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1–152 days) and 61% were female. Clinical manifestations of CRS included low birth weight <2500g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92–1.34). ConclusionsThese preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential.