Rubella-specific IgG Research Articles

Comparison of two commercial ELISA kits for detection of rubella specific IgM in suspected congenital rubella syndrome cases and rubella IgG antibodies in a serosurvey of pregnant women

Enzyme linked immunosorbent assay (ELISA) for antibody identification, is important for laboratory confirmation of rubella infection in different settings. The Enzygnost rubella ELISA, widely used in the World Health Organization (WHO) Global Measles and Rubella Laboratory Network, is expensive and often unavailable. Qualitative and quantitative performance of the Euroimmun ELISA was compared with the Enzygnost ELISA, for detection of rubella specific IgM, using 283 sera collected from suspected congenital rubella syndrome (CRS) patients and IgG antibodies using 435 sera from a serosurvey among pregnant women.Good qualitative agreement was observed for detection of both rubella specific IgM (94.7% agreement and κ of 0.86) and IgG (96.3% agreement and κ of 0.84). Bland–Altman analysis for IgG yielded a mean difference of 0.781 IU/ml with 97.1% values within ±2 SD of the mean difference.Our study findings suggest that Euroimmun ELISA may be considered for detection of rubella specific IgM in suspected CRS cases and rubella specific IgG in surveillance studies.

Measles and rubella seroimmunity in newly arrived adult immigrants in Sweden

Background: International migrants could be considered as a risk group for being susceptible to vaccine preventable diseases such as measles and rubella. However, data on immunity in different migrant groups are scarce. Apart from asylum seekers and refugees, other immigrant groups might also be at risk. We have examined measles and rubella specific IgG antibodies among newly arrived adult immigrants in Skåne region in southern Sweden. In contrast to children, adult immigrants are not offered catch-up vaccinations after arrival.Methods: Stored serum samples from 989 asylum seekers and 984 pregnant women from the antenatal screening program, who had recently settled in Sweden, were analyzed for specific measles and rubella IgG-antibodies. Sex, age, reason for screening and geographic origin were variables entered into a multivariate regression model.Results: There were considerable differences in seroimmunity to measles with regard to geographic origin (44–97%). Measles seroimmunity gaps were most prominent in immigrants from some European regions such as the Baltic countries, the former Yugoslavia and the Newly Independent States and Russia. Seroprotection for rubella varied less between geographic regions (90–99%).Conclusion: Susceptibility to measles among adult immigrants arriving in Sweden varies considerably depending on their geographic origin. Vaccinations against measles and rubella should be offered to groups of immigrants who might be incompletely immunized.

Determination of rubella virus-specific humoral and cell-mediated immunity in pregnant women with negative or equivocal rubella-specific IgG in routine screening

Background: Immunity to rubella-virus (RV) is commonly determined by measuring specific IgG (RV-IgG). However, RV-IgG results may be different and even discordant, depending on the assay used. Cell-mediated immunity is not routinely investigated for diagnostic purposes.Objectives: Our aim was to investigate humoral and cellular immunity of women with negative or equivocal RV-IgG before, and after post-partum vaccination.Study design: A total of 186 pregnant women were included in the study. During pregnancy, humoral immunity was investigated with two RV-IgG immunoassays, an immunoblot and a T-cell mediated immunity test. In the post-partum vaccination period, measuring RV-IgM and RV-IgG avidity allowed us to determine whether women raised a primary or a secondary immune response.Results: Before vaccination, 52.2% women, supposed to be susceptible, had positive anti-E1 RV-IgG indicating strong evidence of previous exposure to RV. All (100%) pregant women who had a positive immunoblot before immunization raised a secondary immune response to vaccination, and 96.8% who had a negative immunoblot before immunization, raised a primary immune response to vaccination. All women who raised a primary immune response after vaccination had negative anti-E1 RV-IgG and negative cell-mediated immunity.Discussion: These results indicate that individuals can have evidence of protective immunity against rubella despite negative RV-IgG.

Hospital based surveillance of congenital rubella syndrome cases in the pre-vaccine era in Amhara Regional State, Ethiopia: A base line information for the country.

BackgroundRubella virus infection in early pregnancy lead to serious multi-organ birth defects known as congenital rubella syndrome (CRS). The incidence of CRS varies in different populations and the highest burden is found in developing countries in which rubella vaccination is not included in their national immunization programs. In Ethiopia, there is scarcity of data about congenital rubella syndrome. Therefore, the aim of this study was to determine the burden of CRS-related birth defects and its incidence in the pre-vaccine era in Amhara Regional State, Ethiopia.Materials and methodsA cross sectional study was conducted in Dessie, Felege-Hiwot and University of Gondar Referral Hospitals, from December 2015 to August 2017. After getting informed assent from each parent/guardian, blood was collected from infants < 1 year of age for laboratory determination of anti-rubella virus antibodies. Their socio-demographic data and clinical information compatible with congenital rubella syndrome were collected using WHO guideline.ResultsDuring the study period, a total of 50 infants suspected for congenital rubella syndrome were included in the study. All infants suspected for CRS were tested against rubella specific IgM and IgG [for infants ≥ 6 months of age] antibodies using ELISA method. Of these, 9/50 (18%) and 4/14 (28.6%) of them were laboratory confirmed and potential CRS cases, respectively. In the present study, the most common laboratory confirmed defect was ocular manifestations 6 (66.7%) followed by heart related problems 5 (55.6%). In the present study, most of the laboratory confirmed cases (66.7%) were reported among 1–5 months of age infants. In addition, 5 (55.6%) of the infants with laboratory confirmed CRS cases were male and 6 (66.7%) of them were from urban settings. In this study, the incidence of CRS was 0.4 per 1000 live births.ConclusionIn this study, nearly one fifth of the infants had laboratory confirmed congenital rubella syndrome and most of them had multiple rubella associated congenital defects at a time. Most of these congenital anomalies were reported among infants ≥ 1 month of age. Based on our result, the incidence of the CRS was line with the global incidence of the CRS in the pre-vaccine era. Therefore, establishing strong rubella/CRS surveillance system as well as introducing the rubella containing vaccine in the national immunization program might be important to reduce the burden of rubella and CRS in the country.

Rubella virus infections and immune status among pregnant women before the introduction of rubella vaccine in Amhara Regional State, Ethiopia

BackgroundRubella and its associated congenital anomalies have been greatly reduced in most developed countries through use of the rubella vaccine. However, the magnitude of the problem is underestimated and there are no well-established rubella/congenital rubella syndrome prevention and control strategies in many developing countries, including Ethiopia. The aim of this study was to determine the prevalence of rubella virus infections among pregnant women and their immune status before the introduction of rubella vaccine in Amhara Regional State, Ethiopia. MethodsA prospective cross-sectional study was conducted among pregnant women in Dessie, Felege-Hiwot, and University of Gondar referral hospitals, from December 2015 to February 2017. After obtaining written informed consent, socio-demographic data, reproductive history, clinical manifestations, and the possible risk factors for rubella virus infections were collected using a structured questionnaire. The laboratory analysis of rubella-specific antibodies was done using an enzyme-linked immunoassay method on venous blood samples. Data were entered and analyzed using IBM SPSS Statistics version 20. Binary logistic regression was used to determine the strength of association between the dependent variables and covariates. ResultsA total of 600 pregnant women were included in the study. Their mean age was 26.4±5years (range 16–40 years). The overall seroprevalence of rubella infection was 89%. Of the total study participants, 9.5% were positive for rubella-specific IgM antibody, which indicates acute/recent rubella virus infection. In contrast, 79.5% of them had protective levels of rubella-specific IgG antibody and were immune as a result of previous wild-type rubella infection. However, 11% of the pregnant women were negative for both rubella-specific antibodies; these women represent the susceptible group. ConclusionsA large number of pregnant women had acute/recent rubella virus infections at the time of data collection, indicating that the virus is endemic in the study area. More than a tenth of pregnant women were found to be susceptible to acquiring the infection in future pregnancies, with the possible risk of rubella-associated congenital anomalies. Hence screening of all women of child-bearing age before conception and during pregnancy might reduce the devastating effects of the virus on the developing fetus.

Australian rubella serosurvey 2012–2013: On track for elimination?

BackgroundThe World Health Organization has targeted rubella virus for elimination regionally. Australia was one of the first countries to implement a nationally funded rubella immunisation program, in 1971, and conducts regular national rubella serosurveillance studies. We aimed to estimate the seroprevalence of rubella-specific IgG antibody in the Australian population by age and sex in 2012–2013, to compare the results with three previous serosurveys conducted in 1996–1999, 2002 and 2007 and to estimate the effective reproduction numbers (Rn). MethodsThis study used 2729 serum and plasma specimens, randomly selected from a specimen bank collected in 2012–2013 across Australia. Age groups included in the sample ranged from 1 to 49 years. Sera were tested for rubella-specific IgG-antibody using the Enzygnost anti-rubella IgG enzyme immunoassay and classified as positive, negative or equivocal according to rubella-specific IgG concentrations of >7 IU/ml, <3 IU/ml and 3–7 IU/ml, respectively. ResultsThe overall proportions seropositive, seronegative and equivocal for rubella-specific IgG were 92.1% (95% CI, 91.0–93.2), 6.7% (95% CI, 5.7–7.7) and 1.2% (95% CI, 0.8–1.6), respectively. The proportion of males seropositive was significantly lower than females in the 30–34 (83.1% vs. 96.8%, p = 0.003), 35–39 (86.1% vs. 96.3%, p = 0.02) and 40–44 (86.1% vs. 95.7%, p = 0.03) year age groups. Rn for rubella in 2012–2013 was estimated to be 0.33 (95% CI 0.28–0.39). DiscussionThe 2012–2013 national serosurvey showed levels of rubella-specific IgG seropositivity in the Australian population are relatively high with no evidence of decrease compared to previous serosurveys conducted in 1996–1999, 2002 and 2007. The lower proportion of seropositive males aged 30–44 years likely reflects the initial immunisation program targeting females only. To our knowledge this study represents the longest period of serosurveillance following introduction of a nationally funded rubella immunisation program. The lack of evidence of decreasing rubella-specific IgG seropositivity is therefore reassuring for Australia and other countries with longstanding high vaccine coverage.

Rubella seroprevalence among pregnant women in Beijing, China

BackgroundRubella infection in pregnant women can result in serious effects, such as miscarriages, stillbirths, and congenital rubella syndrome (CRS). However, very little is known about the rubella seroprevalence among pregnant women in China.MethodsThis is a cross-sectional and hospital-based study. From June 2016 through March 2017, a total of 324 serum samples from healthy pregnant women were collected in the Shunyi Women and Children’s Hospital of Beijing Children’s Hospital. Rubella-specific IgG antibody was determined by ELISA (Euroimmun, Lübeck, Germany) kits. International assigned cut-off values of ≥10 IU/ml were used to assess the percentage of pregnant women with protective IgG concentrations.ResultsThe total rate of protected individuals was 83.3% (95% CI: 78.9%–87.0%). The protective rates of pregnant women in 17–26 years group, 27–36 years group and 37–46 years group were 84.0% (95% CI: 75.3%–90.1%), 81.9% (95% CI: 74.9%–87.4%) and 84.9% (95% CI: 75.8%–90.9%) respectively. No significant difference in protective rates among the three age groups was found (P = 0.83). There were also no statistically significant correlations between protective rates and gravidity (P = 0.84), parity (P = 0.84), birth place (P = 0.16), residence area (P = 0.58), education (P = 0.40) or occupation (P = 0.65).ConclusionsDespite the generally low vaccination coverage for rubella, most of Chinese pregnant women had potent rubella immunity. However, at least 16.7% of pregnant women were susceptible to rubella, which suggested rubella immunization in Chinese women at or before child-bearing age.

Vaccination Status and Antibody Titers against Rubella and Measles among Japanese Female College Students Majoring in Childcare between 2015 and 2018

In 2014, for the protection of medical workers against measles and rubella infection, the Japanese Society for Infection Prevention and Control (JSIPC) recommended either maintaining antibody titers of seroprotective range or two-dose vaccination. JSIPC defined antibody titers into 3 ranges: seroprotective as expected prevention of infection, seronegative as under detection levels, and seropositive as antibody titers ranged between seronegative and seroprotective. This study aimed to explore the association between the number of vaccine doses received and the antibody titers against measles and rubella among Japanese college students majoring in childcare. A total of 841 female students with no history of measles or rubella were serologically screened at the time of college admission between 2015 and 2018. All 841 students had been vaccinated against measles; 738 (87.8%) received two doses of the measles vaccine and 103 (12.2%) received one dose. Likewise, 839 students, except for two, had been vaccinated against rubella; 719 (85.7%) received two doses of the rubella vaccine and 120 (14.3%) received one dose. We thus found that 107 students (12.7%) were seropositive for measles-specific IgG and 731 (86.9%) attained seroprotective titers. By contrast, in case of rubella-specific IgG, only 462 students (55.1%) attained seroprotective titers, and 371 students (44.1%) were seropositive. The two students without receiving rubella vaccination were classified as seronegative. In conclusion, despite that > 85% of students surveyed had received two doses of measles and rubella vaccines, a substantial number of students remain susceptible to measles and especially rubella at the time of college admission.

Rubella sero-prevalence among children in Kilimanjaro region: a community based study prior to the introduction of rubella vaccine in Tanzania

BackgroundChildhood rubella infection is a mild, self-limiting illness. Rubella infection among pregnant women however, is a major public health concern. Depending on gestation age, it may result in fetal death, stillbirth or a new-born with congenital rubella syndrome (CRS). Maternal antibodies protect young infants from rubella infection and lifelong immunity is acquired by vaccination or post-rubella infection. This study aims at characterizing rubella infection and its epidemiology in the Kilimanjaro region, prior to the introduction of the rubella vaccine in Tanzania.MethodsThis was a population based cross-sectional study, covering all the seven districts in Kilimanjaro region, North-eastern Tanzania. The study population included children of 0 to 36 months of age and their mothers/primary caretakers. A multistage sampling method was used to obtain a representative sample of the children. Interviews were conducted using a structured questionnaire. Dried blood spot (DBS) samples were taken from eligible children. Rubella specific IgG antibodies were detected from eluted serum by enzyme-linked immunosorbent assay (ELISA). Descriptive statistics were used to summarize the data, the difference between groups was tested by Fishers exact test or chi square test as appropriate. Univariate and multivariate analysis was used, with rubella sero-positive groups as dependent variables and the socio-demographic, children, paediatric and parental factors as independent variables, the Odds ratio and their 95% confidence intervals were calculated to assess the strength of association between the dependent and independent variables. A p value less than 0.05 was considered significant.ResultsThe overall rubella sero-prevalence was 1.8%. Rural residence was associated with greater risk for rubella infection. Other family characteristic did not predict rubella infection.ConclusionsThis study highlights the low natural immunity to rubella among children prior to the introduction of rubella vaccine in Tanzania. Our research underscores the need for an effective rubella vaccination program to prevent CRS. More epidemiologic and immunologic studies are needed to guide the vaccination deployment and administration strategy in Tanzania.

Seroprevalence of rubella antibodies and determinants of susceptibility to rubella in a cohort of pregnant women in Canada, 2008–2011

Long term control of rubella and congenital rubella syndrome relies on high population-level immunity against rubella, particularly among women of childbearing age. In Canada, all pregnant women should be screened so that susceptible new mothers can be offered vaccination for rubella before discharge. This study was undertaken to estimate rubella susceptibility in a cohort of pregnant women in Canada and to identify associated socio-economic and demographic factors. Biobanked plasma samples were obtained from the Maternal-Infant Research on Environmental Chemicals (MIREC) study, in which pregnant women were recruited between 2008 and 2011. Socio-demographic characteristics and obstetric histories were collected. Second trimester plasma samples (n=1,752) were tested for rubella-specific IgG using an in-house enzyme-linked immunosorbent assay. The percentage of women with IgG titers <5IU/mL, 5–10IU/mL, and ≥10IU/mL were 2.3%, 10.1%, and 87.6%, respectively. Rates of seronegativity, defined as <5IU/mL, were 3.1% in women who had no previous live birth and 1.6% in women who had given birth previously. Among the latter group, seronegativity was higher in women with high school education or less (adjusted OR (aOR) 5.93, 95% CI 2.08–16.96) or with a college or trade school diploma (aOR 3.82, 95% CI 1.45–10.12), compared to university graduates, and those born outside Canada (aOR 2.60, 95% CI 1.07–6.31). In conclusion, a large majority of pregnant women were found to be immune to rubella. Further research is needed to understand inequalities in vaccine uptake or access, and more effort is needed to promote catch-up measles-mumps-rubella vaccination among socioeconomically disadvantaged and immigrant women of childbearing age.

Prevalence of rubella-specific IgG antibodies in unimmunized young female population.

Context:Rubella is a mild self-limiting disease all over the world; nevertheless, it is of significant public health importance due to its teratogenic effect of congenital rubella syndrome. Rubella vaccine is currently not included in the national immunization program in India. Rubella-specific IgG in the unvaccinated population is a marker of previous rubella infection. Rubella IgG estimation in children will provide data for initiation and necessary modification to the immunization strategy.Aims:In this background, this study was conducted with an aim to know the age-specific susceptibility of acquiring rubella infections and future risk of congenital rubella syndrome (CRS) among girls.Settings and Design:This was a community-based, observational study.Participants and Methods:The study was conducted at a randomly selected rural area Mavoor Panchayath of Kozhikode District, Kerala, among adolescent girls. The estimation of rubella-specific IgG antibody was done by quantitative enzyme-linked immunosorbent assay method. IgG titer value of >15 IU was taken positive, 8–15 IU as equivocal, and <8 IU as negative.Statistical Analysis Used:Statistical analysis was performed using Statistical program for Social science version 16 for Windows. Chi-square test was applied to find out significant difference and Fisher's exact test wherever applicable.Results:The data and blood sample collection was done from 250 girls. The mean IgG titer was 151.93 ± 128.78 IU, and as per the criteria, 68.3% were positive, 28.5% were negative, and 3.2% were equivocal. At this age, majority (68.3%) of the girls get protection by natural infection without any vaccine. Some girls (32%) may remain susceptible to infection during adulthood and pregnancy.Conclusions:Natural rubella infection was widely prevalent among child population and at this age. An immunization policy recommending rubella-containing vaccine is highly desirable to prevent rubella and CRS.

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.

Analysis of Serum Th1/Th2 Cytokine Levels in Patients with Acute Mumps Infection.

Background:The mumps virus is frequently the causative agent of parotitis. There has been no study on serum cytokine levels of acute mumps parotitis except for a few which document cytokine levels in cerebrospinal fluid of mumps meningitis. It is with this notion, our study aimed to find Th1/Th2 cytokine levels from patients with acute mumps parotitis.Materials and Methods:Concentrations of mumps-specific IgM, mumps, measles, rubella-specific IgG antibody, and Th1/Th2 cytokines, namely interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-4, and IL-10 were measured simultaneously in serum from 74 patients (42 pediatric and 32 adult cases), 40 healthy subjects (20 pediatric and 20 adults) and in the supernatant of peripheral blood mononuclear cells stimulated with mumps virus genotype C which served as the positive control. Statistical significance was analyzed between each group by means of Mann–Whitney U-test, Kruskal–Wallis test, and Spearman's rank correlation coefficient test.Results:IgM positivity confirmed acute infection in all 74 patients and of these 67 were vaccinated cases; however, very few of them (10/67) were positive for mumps IgG. We found that IFN-γ, IL-2, and IL-10 showed a statistically significant increase in both pediatric and adult patients with acute mumps infection when compared to healthy controls and values were comparable to the positive control.Conclusion:The Th1 cells play important roles during the acute phase of mumps parotitis.

Seroprevalence of Rubella IgG Antibody among Pregnant Women Attending Antenatal Clinic in Lomé, Togo

Background: In non-immune women in the first trimester of pregnancy, Rubella Virus (RV) infection can lead to congenital rubella syndrome (CRS). In Togo, very little is known about the rubella seroprevalence. Objective: To assess the rate of immunization against Rubella Virus among pregnant women. Methods: Serum samples obtained from 232 pregnant women were tested for rubella-specific IgG antibodies using a commercial ELISA kit. Results: Overall, the seroprevalence of rubella-specific IgG antibodies was 85% (192/226) [CI 95%: 82.7- 87.3%]. All of the seropositive pregnant women had a protective level (titre > 10 UI/mL). The rates of immunization increased with age and gavidity but differences were not statistically significant. Conclusions: The high rate of immunization found, in absence of a routine vaccination program supports the presence of an endemic rubella infection in Lome. To prevent CRS and eliminate RV, free access to vaccination for at least children and women of childbearing age in Togo is advocated.

Characterization of rubella seronegative females in the zambian blood donor community.

Rubella is an acute, contagious viral infection caused by a teratogenic enveloped single-stranded RNA virus, rubella virus, a member of the togaviridae family. Though causing generally mild infections in children and adults, it is a disease of public health importance in pregnant women causing major problems including abortions, miscarriages, and congenital rubella syndrome in more than 20% of the susceptible population. This study was carried out to determine the characteristics associated with rubella seronegativity among female blood donors in Zambia. Rubella-specific IgG antibody levels were measured in the blood serum. Proportions were compared using the Chi-squared test at the 5% significance level, and magnitudes of associations were determined using the odds ratio and its 95% confidence interval. Of the 124 female blood donors tested for rubella IgG 46.0% were aged <20 years. Overall, 66.7% of the participants had never been married. More than half (62.1%) of the participants resided in rural areas of the country. Of the 114 participants with recorded level of education, 50.1% had at least completed secondary school. Out of 43 participants with recorded current employment status, 44.2% were not working for pay. A total of 10 (8.1%) participants were seronegative to rubella IgG antibodies. No factors were associated with seronegativity. Protection against rubella through natural infection appears inadequate to protect the population, increasing the risk of CRS.

Study of Cardiovascular Malformation in Congenital Rubella Syndrome in Two Tertiary Level Hospitals of Bangladesh

Background: Congenital Rubella infection is a serious disabling problem for children resulting in Congenital Rubella Syndrome (CRS). The exact pattern of the CRS related cardiovascular malformation has not yet been well established in Bangladesh. The objective of this study was to observe the pattern of cardiovascular malformation in Congenital Rubella Syndrome. Methodology: This cross-sectional study was conducted in Dhaka Shishu (Children) Hospital and National Institute of Cardiovascular Diseases (NICVD). Total 40 suspected CRS cases were recruited from both indoor and outpatient departments of the two study hospitals. Serum samples were tested for rubella-specific IgM and IgG, visual and hearing assessment, chest radiography and colour doppler echocardiography were performed at appropriate specialized centres. Results: The mean (±SD) age of the study population (n=40) was 6.6 (±5.7) months (range: 0–24 months), 68% children were male and 32% were female. Congenital heart disease (CHD) was found in 78% children. Patent ductus arteriosus was the commonest (47.5%) structural defect followed by pulmonary stenosis (22%), atrial septal defect (17.5%) and ventricular septal defect (17%). The chest X-ray of CHD cases showed cardiomegaly in 71% cases and patchy opacity and/or consolidation in 65% cases. Regarding serological assessment of the 37 patients (3 patients rejected blood collection), 60% cases showed IgG positive and 28% cases revealed positive IgM. Conclusions: Various forms of cardiovascular malformation are present in CRS patients. Treatment modalities differ in each type of CHD and its early detection can reduce childhood mortality and morbidity. DOI: http://dx.doi.org/10.3329/bjch.v38i3.22822 Bangladesh J Child Health 2014; VOL 38 (3) :137-141

Rubella Seroprevalence among the General Population in Dongguan, China.

In order to assess the immunity to rubella infection in Dongguan, China, we conducted a seroprevalence survey on rubella and used ELISA to measure rubella-specific IgG in serum samples. A total of 1,017 individuals aged 0-59 years were selected by multistage cluster sampling. Among them, 904 (88.9%) were seropositive for rubella. Two groups (20-29 and ≥40 years) had seropositivity rates of <90%. In comparison with participants aged ≥20 years, rubella immunization rates were higher in those aged <20 years (83.2% vs. 93.7%, respectively; χ(2) = 28.063, P < 0.001). Among women aged 20-29 years, only 63.8% had antibodies above the protective level. Multivariate analysis revealed that only sex and age were significantly associated with rubella-protective antibody levels. Our results suggest that in the study area, women of childbearing age had a greater serological susceptibility to rubella. Additional vaccinations for rubella of susceptible young adults should be considered, particularly in women of childbearing age.

Seroprevalence of rubella antibodies among adult Egyptian females aged 20-30 years. Is there a need for rubella vaccination?

Egypt adopted a comprehensive strategy to eliminate measles and rubella by conducting a catch up campaign (in 2008) targeting children and young adults in the age group 10-19 years. This study aimed to explore the seroprevalence of rubella among females aged 20 to 30 years in order to provide the Ministry of Health with information to develop future strategies for rubella supplemental immunization activities among women of childbearing age before marriage and conception. A total of 339 females in the age group 20 to 30 were selected. The study group comprised women who attended the central laboratory of the Ministry of Health for checking up before travelling abroad as pre-travel requirements for visa application. The collected serum samples were tested for rubella-specific IgG antibodies. The overall prevalence of rubella antibodies in the study group was 88.2%. Around 5.0% of females, who reported that they had been vaccinated, were susceptible to rubella. Age, history of measles, mumps and rubella (MMR) vaccination and past history of rubella infection were considered factors associated with seropositivity for rubella. The seroprevalence rate of rubella antibodies among our female study group was considered low.

Rubella immunity in women of childbearing age, eight years after the immunization program in iran.

Background:Rubella is a viral disease with a worldwide distribution. Mass vaccination campaigns have increased the vaccine coverage in the world with substantial impact on reduction of rubella infections. In Iran, the national measles-rubella campaign, targeting individuals 5-25 years old, was initiated in 2003 and mass childhood vaccination against measles, rubella and mumps has continued ever since.Objectives:The aim of this study was to evaluate the efficacy of routine vaccination on rubella immunity among women of childbearing age in Babol, north of Iran.Patients and Methods:This cross-sectional study was conducted on 812 women of childbearing age living in Babol, north of Iran, in 2011. Twelve samples were excluded from the study because of inadequate sera amounts. Serum samples were examined for presence of rubella-specific IgG antibodies by means of quantitative ELISA.Results:From a total of 800 samples in this study, rubella IgG seropositivity was seen in 786 (98.3% [95% CI = %97.5-%99.1]) cases. The maximum IgG seropositivity (99.2%) was seen in the age group of 21-25 years old and the lowest immunity (87.7%) was in the group of above 30 years old.Conclusions:Our data indicated that the rate of seropositivity to rubella virus in our population was high, suggesting that vaccination has been successful in Babol, reducing the likelihood of congenital rubella infection.

Testing of IgG and IgM against Rubella Virus in School Girls and Pregnant Women in Hanoi where an Outbreak had occurred

Background: Congenital Rubella Syndrome (CRS) is preventable illness but stays frequent in developing countries where rubella vaccination is not incorporated in national program of vaccination like in Vietnam actually. Aims: This study aimed at obtaining baseline information on acquired immunization status of school girls as well as the rate of susceptibility and rubella infection in pregnant women around a rubella outbreak in Hanoi, Vietnam. Population and methods: During and after the rubella outbreak in 2011, sera from 136 school girls (aged from 14 to 17 years) and 140 pregnant women in Hanoi French hospital were tested for rubella-specific IgG and for rubella-specific IgM (only in pregnant women) by the technique of Electro-Chemiluminescence Immunoassay (ECLIA) (Roche Diagnostics) with cut-off value ≥ 10 IU/mL for IgG and ≥ 0.3 IU/mL for IgM. Results: Rubella-specific IgG antibodies was positive in 125/136 (91.9%) school girls and 119/140 (85%) pregnant women, with strong-to-extreme concentration in 86/136 (63.2%) school girls versus 19/140 (13.6%) in pregnant women (p<0.002). Rubella-specific IgG was negative (susceptible to rubella infection) in 21/140 (15%) and rubella-specific IgM antibodies was positive in 27.9% (39/140) pregnant women, of whom 38 (27.1%) a co-existence of rubella-specific IgG and IgM were documented. Conclusions: This preliminary, baseline per/post epidemic information showed a high rate of acquired immunization in female adolescents but also high rate of susceptibility and very high rate of rubella infection in pregnant women, warranting further comprehensive studies to determine robust, nationwide epidemiological data prior to establishing the national program of immunization against rubella and identify appropriate methods for CRS surveillance in Vietnam.