SUMMARY: Rubella is usually a mild illness, with febrile rash being its main symptom. However, serious consequences of rubella infection can result when the infection occurs during the early stages of pregnancy. After the occurrence of a rubella outbreak in Japan that was observed from 2012 to 2013, 45 infants were reportedly born with congenital rubella syndrome (CRS). We prospectively followed the 15 CRS cases reported in Tokyo to determine the virus shedding periods by using nested reverse transcriptase-polymerase chain reaction to detect rubella virus genes. Throast swabs were used for virus detection. The virus shedding period was measured from birth until the time when the sample last tested positive followed by 2 consecutive negative samples. Kaplan-Meier method was used to estimate the proportion of cases remaining positive for rubella virus genes over time. The proportion of CRS cases shedding virus dropped steadily after birth, dropping to 33.8z at 6 months and 16.9z at 12 months. Our findings also suggested that the earlier the mother's onset of rubella during pregnancy, the longer the infant remained positive. Based on our findings, we believe that infants with CRS should be monitored for rubella virus shedding until 1 year of age.
Using the adverse events monitoring system of Japan, we observed diarrhea cases in approximately 10% of patients who received oral poliovirus vaccine (OPV). This study was conducted to investigate whether diarrhea among children aged 0 to 1 is caused by OPV or by other factors such contact at the doctor's office and/or with others outside the home. We conducted a survey of the health of children after regular health check-ups and after the administration of the OPV. The data from the health check-ups were used as a control for the OPV case group. We compared the first-OPV dose vaccination group as well as the second-OPV dose vaccination group to the health check-up group. For cases of diarrhea, the odds ratio of the OPV group to the health check-up group was 1.776. Our findings strongly suggest that post-OPV cases of mild diarrhea are closely related to the administration of the OPV.
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