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At least 19 recordsLinked to original sources
PubMed1998

The impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia.

OBJECTIVES: To describe the impact of rubella immunisation on the incidence of rubella, congenital rubella syndrome and rubella-related terminations of pregnancy in South Australia, and to identify factors associated with a re-emerging problem. DESIGN AND METHODS: A population-based descriptive study using data from South Australian notifications of disease, births and terminations of pregnancy, the rubella immunisation programme, antenatal rubella antibody screening and paediatric hospital case records. SETTING: South Australia (population 1.48 million people; 20,000 births per year). MAIN OUTCOME MEASURES: Incidence of rubella (age-sex specific), congenital rubella syndrome and rubella-related terminations of pregnancy; antenatal rubella sero-positive rates; rubella immunisation uptake rates. RESULTS: Rubella notification rates in 1990-1996 were significantly higher for males than females for ages 15-34 years. There were five cases of congenital rubella syndrome notified in 1980-1996 compared with at least 20 confirmed or compatible cases in 1965-1979. Rubella-related terminations of pregnancy are now rare, with the last termination for maternal rubella being in 1993. The antenatal rubella sero-positive rate in 1995 was 96.7%, but was significantly lower among Asian women born overseas (78.6% among those 30 years or older). Vaccination uptake rates in schoolgirls decreased between 1990 and 1994 (91.2% to 86.9%). CONCLUSIONS: Since the introduction of rubella immunisation, the incidence of rubella infection among women of reproductive age, and of rubella-related terminations, has fallen. Congenital rubella syndrome has not been notified since 1990 but its risk persists with a recent increase in rubella notifications, a fall in school immunisation rates, a relatively low antenatal sero-positive rate among older Asian women born overseas and the trend towards giving birth at older ages. Effective immunisation programmes must be maintained, particularly in schools and for young children and migrant women.

Abortion, Induced↗
PubMed1997

The epidemiology of rubella in England and Wales before and after the 1994 measles and rubella vaccination campaign: fourth joint report from the PHLS and the National Congenital Rubella Surveillance Programme.

The national immunisation campaign carried out in the United Kingdom in November 1994 was designed to give children aged 5 to 16 years of age a single dose of a combined measles and rubella vaccine. Its main objective was to prevent an epidemic of measles predicted in school age children. The rubella component of the vaccine was included in order to reduce the high level of susceptibility to rubella in young adult males and thus reduce the risk of transmission from this group to pregnant women. Susceptibility to rubella in children aged 5 to 16 years has fallen from 15.7% to 3.4% since the measles and rubella campaign. Despite this the incidence of laboratory confirmed rubella rose substantially in 1996, largely on account of cases among males aged 17 to 24 years, who were not vaccinated in the 1994 campaign and about 16% of whom are susceptible. The impact of the resurgence on the incidence of infection in pregnancy has been relatively limited, due to the low level of susceptibility in the antenatal population (2% in nulliparous and 1.2% in parous women for 1994/5). No cases of congenital rubella arising from administration of measles and rubella vaccine during the campaign have been identified. The numbers of babies born with congenital rubella and terminations of pregnancy for rubella arising from the 1996 resurgence are expected to be similar to those that followed the 1993 resurgence. The reduction in susceptibility in future cohorts of young men who received measles and rubella vaccine in the 1994 campaign should prevent future resurgences after the year 2000. If a second dose of measles, mumps, and rubella (MMR) vaccine had not been introduced, susceptibility levels in the school age population would have risen to about 12% in the future. The effect of the second dose of MMR vaccine introduced for children aged 4 to 5 years in October 1996 will be assessed through serological surveillance.

Adolescent↗
PubMed1996

A search for persistent rubella virus infection in persons with chronic symptoms after rubella and rubella immunization and in patients with juvenile rheumatoid arthritis.

Peripheral blood polymorphonuclear leukocytes, mononuclear cells, and plasma and nasopharyngeal specimens were obtained from 6 subjects with persistent symptoms following rubella immunization, 1 subject with persistent symptoms following rubella, 11 children with juvenile rheumatoid arthritis, 17 recently immunized control subjects, and 1 control subject with acute clinical rubella. Rubella virus was isolated from the blood or nasopharynx of four of the 18 control subjects. In contrast, rubella virus was not recovered from any specimens from the seven subjects with persistent symptoms following immunization or natural infection or from the 11 children with juvenile rheumatoid arthritis. A polymerase chain reaction assay detected rubella virus in the blood from three of 14 control subjects but not in the blood from two subjects with persistent symptoms following rubella immunization or in that from three children with juvenile rheumatoid arthritis. We have not been able to confirm the findings of others who have reportedly recovered rubella virus from lymphocytes of persons with persistent symptoms following rubella or rubella immunization.

Adolescent↗
PubMed2001

Control and prevention of rubella: evaluation and management of suspected outbreaks, rubella in pregnant women, and surveillance for congenital rubella syndrome.

Outbreaks of rubella continue to occur in the United States despite widespread use of the measles-mumps-rubella (MMR) vaccine. Throughout the mid- to late-1990s, rubella outbreaks were characterized by increased numbers of cases among adults born in countries that do not have or have only recently instituted a national rubella vaccination program. To address this change in disease epidemiology, CDC's National Immunization Program (NIP) developed the following recommendations in conjunction with public health officials in the field. Public health officials should implement appropriate responses to reports of suspected rubella to determine if an outbreak exists, evaluate its scope, and implement appropriate control measures. Health-care providers should be aware of the need for rubella prevention and control among women of childbearing age and of the appropriate follow-up for pregnant women exposed to rubella. Comprehensive surveillance for congenital rubella syndrome should begin during a rubella outbreak.

Adolescent↗
PubMed1997

Control of rubella and congenital rubella syndrome (CRS) in developing countries, Part 2: Vaccination against rubella.

In 1995-96 we conducted a review of rubella immunization strategies. Worldwide, 78 countries (more than one-third) reported a national policy of using rubella vaccine. This was closely related to country economic status. Based on the United Nations country classification, rubella vaccine is used in 92% of industrialized countries, 36% of those with economies-in-transition, and 28% of developing countries. Cases of congenital rubella syndrome (CRS) may be prevented as follows: by providing direct protection to women and/or schoolgirls (a selective vaccination strategy); by vaccinating boys and girls to provide indirect protection by reducing the transmission of rubella virus (a childhood vaccination strategy); or by a combination of these approaches (a combined strategy). A combined strategy was most commonly reported (60% of countries); seven countries (9%) reported a selective strategy; and 24 countries (31%) reported only childhood immunization. Experience has shown that it is essential to include vaccination of women of childbearing age in any rubella control strategy. Childhood vaccination alone may pose a risk of an increase in CRS cases. Although many countries have introduced rubella vaccine, few report any data on the impact of vaccination. Countries using rubella vaccine need to establish surveillance for rubella and CRS and monitor coverage in each of the target groups.

Adolescent↗
PubMed1997

The role of rubella-immunoblot and rubella-peptide-EIA for the diagnosis of the congenital rubella syndrome during the prenatal and newborn periods.

Rubella infection during the first trimester of pregnancy can cause the congenital rubella syndrome (CRS). Patients with CRS were shown to have a decreased humoral and cellular immunity. It is not known whether asymptomatic newborns who had experienced intrauterine infection with rubella virus (RV) differ in their antibody response from newborns with CRS. In this study we compared both groups for a difference which might be a useful diagnostic criterion for CRS during the prenatal and newborn periods. We used the nonreducing Rubella-Immunoblot and the Rubella-IgG-Peptide-Enzyme Immunoassay (EIA) to determine the antibodies directed to rubella proteins E1, E2 and C. The results showed that only newborns with CRS who had experienced RV infection during the first 12 weeks of gestation showed significantly reduced levels of antibodies directed to both the linear RV E1 epitope (SP 15) and the topographic RV E2 epitope. Asymptomatic newborns infected mostly later than week 10 of gestation showed normal levels of antibodies. These data suggest that the lack of antibody response in CRS is linked to the immaturity of the fetal immune system during the first trimester of gestation. Rubella-IgG-Peptide-EIA and Rubella-Immunoblot should be used additionally for CRS diagnosis in the prenatal/newborn periods. These results may have an impact on the early treatment of late-onset symptoms of CRS patients.

Antibodies, Viral↗
PubMed1986

Rubella-associated arthritis. I. Comparative study of joint manifestations associated with natural rubella infection and RA 27/3 rubella immunisation.

Joint manifestations observed during the course of a prospective RA 27/3 rubella immunisation trial were compared with those observed during an intercurrent wild rubella epidemic in an outlying community. Among 44 rubella haemagglutination inhibition (HAI) negative females ranging in age from 17 to 33 years who received rubella vaccine, six (13.6%) developed acute polyarticular arthritis within two to four weeks postvaccine and two (4.5%) had continuing or recurrent arthropathy lasting longer than 18 months. In contrast, among 23 females ranging in age from 11 to 39 years undergoing wild rubella infection, 12 (52.2%) developed acute polyarticular arthritis and seven (30.4%) had recurrent arthropathy 18 months postinfection. Among 23 males ranging in age from 13 to 54 years undergoing wild rubella infection, only two (8.7%) developed acute arthritis and both individuals had continuing joint manifestations 18 months postinfection. Wild rubella infection in adult populations is associated with a higher incidence, increased severity, and more prolonged duration of joint manifestations than is seen after RA 27/3 rubella immunisation.

Adolescent↗
PubMed1988

Rubella-specific IgG subclass avidity ELISA and its role in the differentiation between primary rubella and rubella reinfection.

An antiglobulin enzyme-linked immunosorbent assay for rubella-specific IgG1 and IgG3 was adapted to measure antibody avidity by incorporating a mild protein denaturant, diethylamine (DEA), into the serum diluent. Sera were tested at varying dilutions, both with and without DEA, if they contained sufficient specific IgG1 or IgG3. The optical density (OD) was measured and curves were plotted. The highest OD (V) was noted and halved (V/2). The distance between the OD curves at V/2 was measured as the DEA shift value. Sera were examined from people whose sera contained rubella-specific antibodies as a consequence of infection or vaccination in the distant past (24 sera), recent primary rubella (66 sera), symptomatic reinfection (11 sera) or asymptomatic reinfection (64 sera). For specific IgG1 the DEA shift value was less than 0.6 for cases of rubella in the distant past, compared with greater than 0.8 for the first month after primary infection. The maximum DEA shift value for the sera from cases of reinfection was 0.65. No serum from cases of rubella in the distant past contained sufficient specific IgG3 to estimate avidity. The sera collected within 1 month of onset of primary rubella gave DEA shift values greater than 0.7 compared with sera from reinfections, which gave DEA shift values less than 0.6, except for two sera from a case of symptomatic reinfection. Thus the assessment of specific IgG subclass avidity is of value in differentiating serologically primary rubella from reinfection.

Antibodies, Viral↗
PubMed1975

[Passive immunization against rubella: studies on the effectiveness of rubella-immunoglobulin after intranasal infection with rubella vaccination virus].

The effectiveness of high-titre rubella immunoglobulin was tested on rubella-susceptible female juveniles or young adults after intranasal immunization with rubella strain RA 27/3, 20 ml of rubella immunoglobulin having been administered intramuscularly to 56 subjects at different times (1, 3 and 5 days) after the immunization. The effect was demonstrated by seroconversion and virus isolation from the throat. In the control subjects (26) the secroconversion was 96% and in 42% of subjects virus was demonstrated in the throat. Early administration of rubella immunoglobulin (up to three days after immunization) depressed the seroconversion rate to 55% and virus isolation rate to 17.5%. Later administration (five days after immunization) increased the conversion rate to 81%, the isolation rate to 31%. There were no serious side effects of the immunization and the injection of the immunoglobulin. The results indicate that on early administration of an adequate amount of high-titre rubella immunoglobulin a protective effect can be expected, although this favourable effect-obtained in the conditions of this study-cannot be unreservedly transposed to the situation in wild virus infections.

Adolescent↗
PubMed1998

Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP).

These revised recommendations of the Advisory Committee on Immunization Practices (ACIP) on measles, mumps, and rubella prevention supersede recommendations published in 1989 and 1990. This statement summarizes the goals and current strategies for measles, rubella, and congenital rubella syndrome (CRS) elimination and for mumps reduction in the United States. Changes from previous recommendations include: Emphasis on the use of combined MMR vaccine for most indications; A change in the recommended age for routine vaccination to 12-15 months for the first dose of MMR, and to 4-6 years for the second dose of MMR; A recommendation that all states take immediate steps to implement a two dose MMR requirement for school entry and any additional measures needed to ensure that all school-aged children are vaccinated with two doses of MMR by 2001; A clarification of the role of serologic screening to determine immunity; A change in the criteria for determining acceptable evidence of rubella immunity; A recommendation that all persons who work in health-care facilities have acceptable evidence of measles and rubella immunity; Changes in the recommended interval between administration of immune globulin and measles vaccination; and Updated information on adverse events and contraindications, particularly for persons with severe HIV infection, persons with a history of egg allergy or gelatin allergy, persons with a history of thrombocytopenia, and persons receiving steroid therapy.

Adolescent↗
PubMedDate not supplied

Rubella IgG total antibody avidity and IgG subclass-specific antibody avidity assay and their role in the differentiation between primary rubella and rubella reinfection.

The total rubella IgG antibody avidity ELISA, as described by Hedmann for differentiation between acute primary rubella and reinfection, persisting or non-specific IgM antibodies were evaluated in 212 sera of four categories of patients with known history (n = 149) and in one group (n = 39) of patients with a history of unclear nature. The development of the IgG ratio (avidity) from low (less than 30%) to higher levels (greater than 30%) was determined in 146 sera from 96 cases with acute primary rubella between days 1 to 256 after onset of exanthem, with a borderline between low (less than 30%) and high (greater than 30%) avidity after four weeks after onset of exanthem. From seven days to 14 years following vaccination, the IgG ratio increased more slowly following vaccination, with a useful borderline at 2 1/2 months. In 80 sera from 13 women with reinfection during pregnancy, six infants with rubella embryopathy, and 19 pregnant women with rubella IgM antibodies detected during antenatal screening, the total IgG ratio ranged between 48% and 100%, indicating a previous infection. The diagnostic value of the IgG subclass-specific antibody avidity assay was investigated in 40 of the 251 sera. The results confirmed those of the total IgG avidity assay. Both tests are of additional help for differentiating serologically primary rubella from reinfection or recent from previous vaccination.

Adolescent↗
PubMed1978

Pathogenesis of the rubella exanthem: distribution of rubella virus in the skin during rubella with and without rash.

In a previous assessment of the role of rubella virus in the pathogenesis of the rubella exanthem, virus was consistently isolated from cell cultures of skin biopsy specimens of the rash, and it was concluded that presence of virus in the skin was essential to evolution of the rash. For determination of whether virus is present in the skin only in association with rash, punch biopsies were performed concurrently on areas of skin with and without rash. Among paired skin specimens of 16 patients, virus was isolated from sites of rash in 12 and from the uninvolved skin in 10. In another patient, shown by serologic response and recovery of virus from the pharynx to have rubella without a rash, virus was also isolated from the skin. It is concluded that rubella virus is widely disseminated in the skin of patients with rubella irrespective of the presence or distribution of the rash, and that the presence of virus in the skin, although a constant feature of the disease, is only one of the factors involved in the pathogenesis of the exanthem.

Biopsy↗
PubMed1980

Arthritis related to rubella: a complication of natural rubella and rubella immunization.

The success of the childhood rubella immunization program has caused an upward shift in age of those susceptible to rubella. An associated increase has taken place in the incidence of rubella-related arthritis, which occurs more often in the post-pubertal population. Fortunately, however, the arthralgia-arthritis syndromes of naturally acquired rubella and those associated with vaccination are usually transient and mild.

Adolescent↗
PubMed1992

Persistent rubella-specific IgM reactivity in the absence of recent primary rubella and rubella reinfection.

Between two and seven sera from cases of persistent detection of rubella-specific IgM for periods in excess of 2.5 months, but in the absence of recent primary rubella or rubella reinfection, were examined for rheumatoid factor, heterophile antibody, and IgM reactivity against toxoplasma and a number of viruses. The relative avidity of the rubella-specific IgG1 has been assessed in all the sera by two methods. None of the sera contained rheumatoid factor or heterophile antibody, nor did any contain detectable concentrations of IgM specific for any of the panel of antigens apart from five sera which contained low concentrations of IgM specific for some coxsackieviruses B. No sera were positive for low avidity specific IgG1 although three did give equivocal results with one avidity test and one gave equivocal results with the second avidity test.

Animals↗
PubMed1983

Seroepidemiologic studies on rubella in Fukuoka in southern Japan during 1965-1981: rubella epidemic pattern, endemicity and immunity gap.

The epidemiology of rubella in most areas of Asia has not been defined. In Fukuoka city in southern Japan, rubella epidemics occurred in 1956-58, in 1966 and in 1976-77. During the first halves of the 1960s and 1970s, neither epidemic nor endemic clinical rubella occurred. Rubella mass vaccination for girls of 14 years of age started in 1978. Rubella seroepidemiologic studies were performed in 1965, 1974, 1978-79 and 1981 in Fukuoka city. Current studies indicated that children of 6-10 years of age during the epidemics of 1956-58, 1966 and 1976-77 were infected with rubella in 72%, 37% and 57% of cases, respectively. Just before the epidemics of 1966 and 1976-77 100% of the children under nine years of age had no antibodies to rubella indicating absence of recent outbreaks. Whereas 95% of the population (young women of 15-18 years of age in 1981) which participated in the rubella mass vaccination programme since 1978 have rubella Hl antibodies, 46% of the nonparticipating population (19-23 years of age in 1981) remains susceptible to rubella. These facts indicate that rubella epidemics occurred in 1956-58, 1966 and 1976-77, that the magnitude of each epidemic was different, and that there were intervals without endemicity in the inter-epidemic periods. However, after the nation wide rubella epidemic in 1975-77, endemic rubella continued, and rubella epidemics again occurred in 1980-82. The unique rubella epidemic pattern in Japan may be changing in the 1980s to that which existed in most areas of the world where rubella was endemic with periodic increased incidence of epidemicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗