Seroepidemiological profile of pregnant women after inadvertent rubella vaccination in the state of Rio de Janeiro, Brazil, 2001-2002.

OBJECTIVES: To analyze postvaccination serological status in pregnant women inadvertently vaccinated against rubella in the state of Rio de Janeiro, Brazil. METHODS: This was a cross-sectional study of pregnant women 15 to 29 years old, vaccinated against rubella and measles from November 2001 to March 2002, who were unaware of their pregnancy at the time of vaccination or who became pregnant within 30 days thereafter. They were tested for rubella-specific immunoglobulin M (IgM) and G (IgG) and classified as immune (IgM-negative, IgG-positive, tested within 30 days after vaccination), susceptible (IgM-positive after vaccination) or indeterminate (IgM-negative, IgG-positive, vaccination-serological testing interval greater than 30 days). RESULTS: Of 2 292 women, 288 (12.6%) were susceptible, 316 (13.8%) immune, 1 576 (68.8%) indeterminate, 8 (0.3%) ineligible, and 104 (4.5%) lost to follow-up. IgM seropositivity by vaccination-serological testing interval was 16.1% (相似文献   

Interpreting the effectiveness of a national antibiotic policy and comparing antimicrobial use between countries

Rubella infection in early pregnancy is associated with severe consequences in the developing fetus. In Hong Kong, 8-11% of women of child-bearing age are still susceptible to rubella infection. Therefore, rubella immune status of healthcare workers who may have contact with pregnant women is of particular concern. Rubella immunity of healthcare workers in a Department of Obstetrics and Gynaecology was analysed. In the one and a half years of study, 134 healthcare workers voluntarily submitted blood samples for immunity determination and 16.4% of them were susceptible to rubella infection. A substantial proportion of healthcare workers of childbearing age (14%) was negative for rubella antibody. Susceptible healthcare workers have a risk of acquiring and subsequently transmitting the potentially teratogenic rubella infection to their patients. There is a need to review the rubella immunization policy for healthcare workers in Hong Kong.     

Susceptibility to infectious rash illness in pregnant women from diverse geographical regions

Varicella-zoster (VZV), rubella (RV) and parvovirus B19 (B19V) infections are important causes of rash illness in pregnancy, due to their potential adverse impact on both mother and fetus. We determined susceptibility to these infections in pregnant women attending our hospital in 2002. Age and nationality were recorded. Sera were tested for VZV, RV, and B19V antibody by enzyme immunoassay. Of 7,980 women screened for VZV IgG, 11.3% were seronegative and therefore susceptible to infection. Across different worldwide regions, 6.9% of Irish and other Western European women were susceptible to VZV, compared to 19.7% of other women tested (p < 0.001), most of whom were from Central and Eastern Europe, sub-Saharan Africa and Asia. Of 7,872 women screened for RV IgG, 2.3% were seronegative. Few Irish (0.6%) or other Western European women (0.7%) were rubella non-immune, but 5.5% of women from other regions tested were susceptible to rubella (p < 0.001). A random subset of 1,048 women were tested for B19V IgG. About 38% were susceptible, varying from 22% to 63% across the different regions studied. There are important differences in immunity to these infections and so of potential risk of an adverse outcome in indigenous and immigrant pregnant women in Ireland.     

深圳市宝安区育龄妇女风疹病毒免疫力状况调查

目的:通过对育龄妇女风疹抗体水平的调查,了解育龄妇女对风疹病毒免疫力状况,为科学接种疫苗提供理论根据。方法:采用定量间接ELISA方法对深圳市宝安区20～40岁1291例育龄妇女进行风疹病毒免疫力检测。结果:深圳市宝安区育龄妇女风疹病毒无保护力人群占到15.88％,明显高于80年代的调查结果;另外,20～29岁年龄组、30～40岁年龄组风疹病毒无保护力人群分别为19.4％,13.5％,两组比较统计学有显著差异(P<0.05)。结论:约有1/5生育活跃期育龄妇女对风疹病毒无保护力,孕前应加强风疹疫苗注射,以减少先天性风疹综合征的发生。     

2005年山东省部分孕期妇女风疹易感性调查

[目的]了解山东省孕期妇女风疹易感性水平,为调整风疹疫苗免疫策略提供依据。[方法]2005年,采集不同地区到医院准备分娩的20~40岁孕妇血清,采用间接酶联免疫吸附定量法检测风疹IgG抗体。[结果]检测标本3 788份,风疹抗体阳性(>20 IU/ml)的2 942人,阴性(<10 IU/ml)的314人,临界值(10~20 IU/ml)的532人,易感(临界值和阴性者)合计846人,易感率为22.33%。几何平均抗体含量(CMT)为34.93 IU/ml。不同地区风疹易感率和CMT的差异均有统计学意义(P<0.01);风疹易感率有随年龄增长而增高的趋势(P<0.01)。[结论]山东省近1/4的孕妇为风疹的易感者,有必要对育龄期妇女开展风疹疫苗接种。     

Seroprevalence of rubella in school girls and pregnant women

Many studies have been assigned to investigate the surveillance of congenital rubella syndrome, acquired rubella and seroprevalence in different countries to determine the new vaccination program and national vaccination schedules. Seroprevalence of rubella in Turkey is still insufficient and national immunization schedules do not include routine rubella vaccination. In this study we aimed to investigate the seroprevalence of rubella at child bearing age in an unvaccinated population in Adana, southern Turkey, to help determine whether routine rubella vaccination is necessary, if so when it should be administered. Ninety-four school girls aged 12–18 years living in Adana were selected for the study and stratified according to the socioeconomic status of their parents and evaluated for rubella antibodies. One hundred pregnant women aged 18–25 years and 100 pregnant women aged 26–35 years were sampled rubella antibodies. Rubella specific IgG antibody was measured qualitatively and quantitatively by using microparticule enzyme immune assay technology. Rubella specific IgG antibody was positive in 87–94 school girls (92.5%). The geometric mean rubella specific IgG antibody value was found be 148.14 IU/ml. No correlation was found between socioeconomic status and rubella seropositivity (p = 0.6521). In all pregnant women rubella specific IgG antibody was found to be positive. In conclusion rubella vaccination should be considered carefully in developing countries. Because of the high seropositivity to rubella in our region we do not recommend rubella vaccination in early childhood. Yet this is a preliminary study and further studies with larger population size are needed to determine the national immunization policy for rubella.     

Rubella seroprevalence in an unvaccinated pregnant population in Malatya, Turkey

BACKGROUND: Controlling congenital rubella by 2010 is one of the targets of the World Health Organization. Most European countries currently include rubella vaccine in their national immunization programmes, but not yet in Turkey. OBJECTIVES: To define rubella seroprevalence in pregnancy in Malatya, Turkey. STUDY DESIGN: A cross-sectional interview survey was conducted among pregnant women living in Malatya province from November 2003 to May 2004, together with a follow-up component. METHODS: Stratified probability proportional to size sampling methodology. A total of 824 pregnant women from 60 clusters were enrolled. After obtaining informed consent, participants' socio-demographic and fertility characteristics were collected by interview questionnaire. Various blood samples were drawn. After storing serum samples at -20 degrees C for 6 months, anti-rubella IgM and IgG titres were studied by micro ELISA. Only 803 sera were eligible for serological study. RESULTS: Of the 803 samples tested for rubella antibodies, 753 cases (93.8%) had anti-rubella IgG positivity, indicating past infection. Five of the pregnant women (0.6%) had both anti-rubella IgM and IgG positive results, suggesting a recent infection. The remaining 45 women (5.6%) were seronegative for both antibodies. Seroprevalence was not associated with age or urban/rural residency. All the five anti-rubella IgM positive women were in the second trimester of pregnancy. CONCLUSIONS: As 5.6% of pregnant women were susceptible to rubella during pregnancy, and five of them had already had a recent infection, immunization efforts should be directed at babies and adolescents.     

Rubella susceptibility in pregnant women and results of a postpartum immunization strategy in Catalonia,Spain

BackgroundElimination of congenital rubella syndrome depends not only on effective childhood immunization but also on the identification and immunization of rubella susceptible women. We assessed rubella susceptibility among pregnant women and evaluated the adherence and response to postpartum immunization with measles, mumps and rubella (MMR) vaccine.MethodsCross-sectional study of women who gave birth at the Hospital Clinic de Barcelona (Spain) between January 2008 and December 2013. Antenatal serological screening for rubella was performed in all women during pregnancy. In rubella-susceptible women, two doses of MMR vaccine were recommended following birth. We evaluated rubella serological response to MMR vaccination in mothers who complied with the recommendations.ResultsA total of 22,681 pregnant women were included in the study. The mean age was 32.3 years (SD 5.6), and 73.6% were primipara. The proportion of immigrants ranged from 43.4% in 2010 to 38.5% in 2012. The proportion of women susceptible to rubella was 5.9% (1328). Susceptibility to rubella declined with increasing maternal age. Immigrant pregnant women were more susceptible to rubella (7.6%) than women born in Spain (4.6%). Multivariate analyses showed that younger age (≤19 years) aOR 1.7 (95% CI 1.1–2.5), primiparas aOR 1.3 (95% CI 1.1–1.5) and immigrant women aOR 1.6 (95% CI 1.4–1.8) were more likely to be susceptible. The second dose of MMR vaccine was received by 57.2% (718/1256) of rubella-susceptible women, with the highest proportion being immigrant women compared with women born in Spain. After vaccination, all women showed rubella immunity.ConclusionsThe higher rubella susceptibility found in the three youngest age groups and in immigrant women highlights the relevance of antenatal screening, in order to ensure identification and postpartum immunization. The postpartum immunization strategy is an opportunity to protect women of childbearing age and consequently prevent occurrence of CRS, and to increase vaccination coverage against rubella and other vaccine-preventable diseases.     

风疹病毒疫苗的研究进展

目的了解上海市松江区孕妇麻疹和风疹IgG抗体水平,为预防初免前婴儿麻疹、风疹及新生儿先天性风疹综合征的发生提供科学的免疫策略。方法分别于2013年5—8月和2014年4—6月,按照就诊顺序用随机数字法随机抽取松江区妇幼保健院和第一人民医院产科15~岁、25~岁、35~岁3个年龄组600名健康孕妇进行监测,采用酶联免疫吸附试验(ELISA)检测每名孕妇血清的麻疹和风疹IgG抗体水平,采用SAS 9.2软件对相关数据进行统计学分析。结果600名健康孕妇的麻疹IgG抗体几何平均浓度和阳性率分别为885.58 mIU/mL和86.50%,风疹IgG抗体几何平均浓度和阳性率分别为197.85 IU/mL和82.17%;非本市户籍孕妇的麻疹和风疹抗体水平均高于本市户籍孕妇,各年龄组间孕妇麻疹和风疹抗体水平差异无统计学意义(P均＞0.05)。结论为控制初免前婴儿麻疹、风疹的发病及新生儿先天性风疹综合征的发生,应在育龄期妇女中开展含麻疹和风疹成分疫苗的补种。     

芜湖市妊娠期妇女风疹抗体的血清学研究

目的了解芜湖市妊娠期妇女风疹抗体情况。方法通过调查问卷收集调查对象的有关信息,使用ELISA方法对样本中风疹IgG抗体进行检测。结果本研究显示风疹自然感染率达到74.29%,同时,风疹疫苗接种率极低;单因素分析显示,不同教育水平,经济收入及年龄,妊娠期妇女的抗体阳性率无明显差异。结论风疹的自然感染率较高,而风疹疫苗接种率极低,因此采取相应的预防措施与实施育龄期妇女风疹疫苗的接种十分必要。     

Outcome of asymptomatic infection with rubella virus during pregnancy.

We have tried to detect prenatal infection in 34 infants whose mothers were re-infected with rubella virus during pregnancy and in six infants whose mothers had primary subclinical rubella during pregnancy. Two methods of assessment were used: first, serum obtained soon after birth was tested for IgM antibody; secondly, serum obtained after the age of 8 months was tested for specific IgG. The 34 women with re-infections had increases in IgG antibody titre but no IgM response. No evidence of prenatal infection was found in 33 of their 34 infants. One infant was found to have IgG antibody at the age of 11 months. This infant was IgM-negative at birth and had a rubelliform rash at the age of 5 1/2 months; it therefore probably contracted post- rather than pre-natal infection. Fetal infection from maternal re-infection during pregnancy is probably rare. The six women with primary subclinical rubella produced both IgG and IgM classes of antibody. Three of their six infants showed serological evidence of intrauterine infection. One, infected when its mother was 8 weeks pregnant, had clinical evidence of congenital rubella. Primary subclinical rubella during pregnancy therefore carries a significant risk of fetal infection. Because of the difference in outcome, great care should be taken to distinguish between primary infection and re-infection when investigating symptomless increases in antibody titre after contact with rubella during pregnancy.     

Seroepidemiology study of rubella antibodies among pregnant women from seven Asian countries: evaluation of the rubella vaccination program in Taiwan

During 2003-2004, approximately 13% of birth in Taiwan was given by foreign-born females. The aims of this study were to compare the seroprevalence of rubella antibodies between Taiwan-born and foreign-born pregnant women and evaluate the effect of rubella vaccination program in Taiwan. We reviewed the rubella antibody test results of 5007 women during routine pregnancy check-ups at Fooyin University Hospital during 1999-2002. In Taiwan-born women, rubella antibody was undetectable in 29.2%, 7.3%, and 8.3% of the cohorts born before 1971, between 1971 and 1976, and after 1976, respectively. In the cohorts born between 1971 and 1976 and after 1976, pregnant women born in China, Vietnam, Indonesia, and Philippines had significant higher chances of being susceptible. Our results suggested that the voluntary adult vaccination program was not as effective as the school or wipe-out programs. Both Taiwanese women born before 1971 and foreign-born women were more likely to be susceptible to rubella. The introduction of 'catch-up' immunization program and enforcement of the checking of immunization record and/or blood test before pregnancy for these women are necessary in preventing CRS.     

122对母婴风疹病毒抗体水平检测及意义

目的了解孕产妇及其新生儿血液中风疹病毒抗体水平,评估孕产妇及其新生儿对风疹病毒的易感性,为预防和控制先天性风疹综合征提供科学依据。方法随机采集2011年吉林大学第二医院妇产科住院部分孕产妇及其配对新生儿血液,应用酶联免疫吸附法(ELISA)检测血清中风疹病毒特异性抗体。运用统计学软件SPSS对可能影响孕产妇及其新生儿风疹抗体水平的因素进行分析。结果 122名孕产妇风疹抗体免疫球蛋白G(IgG)阳性率为77.8%,新生儿风疹抗体IgG阳性率为82.6%。一对母婴风疹IgG抗体均>2 500 IU/ml,其母亲的风疹抗体免疫球蛋白M(IgM)阳性。母体内风疹病毒IgG抗体阳性率随年龄增加而下降。母传抗体增高的平均倍数为1.5倍,降低的倍数为2.0倍。结论及时监测孕产妇及其新生儿风疹IgG及IgM抗体,提高育龄妇女风疹免疫力,是减少先天性风疹综合征发病的有效手段。     

Inadvertent rubella vaccination of pregnant women: evaluation of possible transplacental infection with rubella vaccine

During mass campaign for measles/rubella vaccination on December 2003 in Iran, many pregnant women have vaccinated mistakenly. These women were grouped to susceptible and immune against rubella before vaccination by the status of IgG avidity response to rubella vaccine, then susceptible women were followed up to delivery time and their neonates were followed up to one year. In five neonates that were born from susceptible women, rubella-specific IgM has detected in cord blood sera, but they have not shown signs compatible to congenital rubella syndrome.     

Rubella virus antibodies in women of childbearing age.

Rubella is a common contagious disease with mild constitutional symptoms, but when it occurs during pregnancy there is significant risk of severe damage to the fetus. A study was undertaken to determine the level of rubella virus antibodies in females in the childbearing age (from 15-40). A total of one hundred and thirty sera were examined for rubella-specific IgG antibodies by hemagglutination inhibition (HAI) test. Ninety out of these sera were examined also by ELISA, for comparative purposes. It was found that, by HAI test, the percentage of antibody positive sera in the females was 72.2% (HAI titer greater than 1:16), while by the more sensitive ELISA test, the percentage of antibody positive sera was 92.2% (50 IU/ml antirubella IgG). The most susceptible females were in the age group of 20-25 years. The need to ensure the protection of seronegative susceptible women of childbearing age by immunization before marriage or pregnancy is emphasized. ELISA is more sensitive, rapid, specific, reproducible and easily adaptable test to large scale screening than the conventional HAI test.     

Reasons for rubella susceptibility among pregnant women in west Lambeth.

One hundred and thirty-three pregnant women who delivered at St Thomas' Hospital, in 1990 were noted to require rubella vaccination post partum. Fifty-three (39%) had completed a telephone questionnaire in order to determine reasons for susceptibility to rubella. Laboratory reports confirmed that 92 women were rubella seronegative and 27 had low levels of antibody. Of the 53 women interviewed, 25 gave a history of one or more rubella immunizations, 20 had no history of immunization and vaccination history was unknown for eight. Eleven of the 20 unvaccinated women had not been at school in the UK between 11 and 14 years of age. Eighty-seven per cent of the patients' general practitioners had no knowledge of their patients' rubella antibody status. Ninety-four per cent of the 133 women received rubella vaccine post partum. The Department of Health guidelines should be more vigorously implemented in order to identify and immunize remaining rubella susceptible women of child-bearing age. Susceptibility among women with a history of rubella immunization suggests that the seroconversion rate following rubella immunization in clinical practice may be lower than in vaccine trials.     

北京市昌平区健康人群风疹和流行性腮腺炎抗体水平监测分析

目的了解昌平区健康人群风疹、流行性腮腺炎（简称流腮）抗体水平,为传染病控制工作提供科学依据。方法采集昌平区10个村本市及外省人口血标本共220份,采用酶联免疫吸附试验（ELISA）测定风疹、流腮[gG抗体,同时调查风疹、流腮患病史和免疫史及人口学特征。结果220名调查对象的风疹抗体阳性率为75．00％,其中本市110人抗体阳性率为74．55％,外省110人抗体阳性率为75．45％。风疹IgG抗体浓度均数为64IU／ml,其中1～4岁年龄组最高,为124IU／ml。0～1岁年龄组最低,为3IU／ml;流行性腮腺炎抗体阳性率为80．45％,其中本市110人抗体阳性率为80．91％,外省110人抗体阳性率为80．00％。流腮IgG抗体浓度均数为436IU／mI。其中20～24岁年龄组最高,为664IU／ml,0～1岁年龄组最低,为122IU／ml。结论提高麻风腮疫苗基础免疫接种率,在儿童入学前完成1剂加强免疫,对控制风疹和流行性腮腺炎有重要意义。同时应关注成人尤其是育龄期妇女的免疫接种,以减少先天性风疹综合征的发生。     

Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana

OBJECTIVES: Although rubella serosusceptibility among women of reproductive age in West Africa ranges from 10% to 30%, congenital rubella syndrome has not been reported. In Ghana, rubella immunization and serologic testing are unavailable. Our objectives were to identify congenital rubella syndrome cases, ascertain rubella antibody seroprevalence during pregnancy, and recommend strategies for congenital rubella syndrome surveillance. METHODS: Congenital rubella syndrome cases were identified through prospective surveillance and retrospective surveys of hospital records. A rubella serosurvey of pregnant urban and rural women was performed. RESULTS: Eighteen infants born within a 5-month period met the congenital rubella syndrome case definitions, coinciding with a 9-fold increase in presentation of infantile congenital cataract. The congenital rubella syndrome rate for this otherwise unrecorded rubella epidemic was conservatively estimated to be 0.8 per 1000 live births. A postepidemic rubella immunity rate of 92.6% was documented among 405 pregnant women; susceptibility was significantly associated with younger age (P = .000) and ethnicity (northern tribes, P = .024). CONCLUSIONS: Congenital rubella syndrome occurs in Ghana but is not reported. Information about congenital rubella syndrome and rubella in sub-Saharan Africa is needed to evaluate inclusion of rubella vaccine in proposed measles control campaigns.     

Seroprevalence of measles and rubella antibodies in pregnant women Haiti, 2012

Background

Haiti had set a national goal to eliminate measles and rubella, as well as congenital rubella syndrome (CRS) by 2010. A 2007–2008 nationwide measles and rubella vaccination campaign targeting 1–19 years, however, reached only 79% of the target population. To assess whether population immunity was adequate to support elimination, we conducted a national serosurvey.

Methods

We systematically selected 740 serum specimens collected from pregnant women in a 2012 national antenatal HIV sentinel serosurvey across four age strata: 15–19, 20–24, 25–29 and 30–39 years. Sera were tested for measles and rubella specific immunoglobulin G antibodies (IgG) using commercial immunoassays. We classified sera as seropositive, seronegative or indeterminate per manufacturer's instructions, and analyzed seroprevalence according to age strata, and rural or urban residence. We assessed immunity by estimating antibody concentrations in international units per milliliter (IU/mL) for seropositive and indeterminate sera. Measles IgG concentrations >0.12 IU/mL and rubella IgG concentrations >10 IU/mL were considered clinically protective.

Results

Of 740 sera, 696 (94.1%) were seropositive and 20 (2.7%) were indeterminate for measles IgG; overall 716 (96.8%) sera had IgG concentrations >0.12 IU/mL. For rubella IgG, 691 (93.4%) sera were seropositive and 1 (0.1%) was indeterminate; a total of 687 (92.8%) had IgG concentrations >10 IU/mL. Measles seropositivity varied across age strata (p = 0.003); seropositivity increased from 88.6% among 15–19 year olds to 98.4% among 30–39 year olds (Cochran–Armitage trend test ≤ 0.0001). Rubella seropositivity did not differ across age strata. There were no statistically significant differences in measles or rubella seropositivity by urban versus rural residence.

Conclusion

Despite previous low vaccination coverage for measles, results from this serosurvey indicate high levels of measles and rubella seropositivity in pregnant women, and contribute to the evidence for measles, rubella and CRS elimination from Haiti by the target date.     

2010-2013年深圳市罗湖区育龄期妇女风疹IgG抗体水平及发病情况

目的 结合罗湖区女性风疹发病情况,重点研究育龄期妇女风疹发病情况及风疹血清IgG抗体水平,为控制风疹疫情,完善风疹免疫策略,预防先天性风疹综合征( CRS) 提供科学依据。方法 在罗湖区体检中心随机抽取四家体检单位,筛选18—35岁育龄期妇女,采集血清标本共164份,用酶联免疫吸附法检查血清风疹IgG抗体,同时分析罗湖区2010-2013年女性风疹发病情况。结果应涵盖所有的结果 育龄期妇女风疹IgG抗体几何平均浓度和阳性率分别为103.1626 IU/mL 和93.3%,各年龄组统计分析 ,差异无统计学意义( χ² =2.7668,P =0．2507;F=1.00,P=0.905)全文类似描述,如此排序,且随年龄增长,风疹抗体水平有所增加;本市和外市的育龄期妇女风疹IgG 抗体阳性率间的差异无统计学意义( χ² = 0．0238,P =0．8774) ,本市和外市的育龄期妇女风疹抗体平均浓度间的差异有统计学意义(F=0.207,P=0.991) ;有接种史、无接种史和接种史不详的育龄期妇女风疹IgG抗体阳性率间的差异无统计学意义( χ² = 2．0691,P =0．3554,F=1.508,P=0.224)。2010—2013年罗湖区女性风疹发病年龄主要集中在15—35岁,占女性发病人数的74.84%,2010—2013年所占比例分别为75%、75.63%、75%、64.7%。结论 对育龄期妇女加强接种风疹疫苗( 或含有风疹疫苗的联合疫苗) ,提高育龄妇女风疹抗体水平,是控制小月龄发病和先天性风疹综合征的重要手段。