Clinical epidemiological and molecular aspects of rubella outbreak with high number of neurological cases, Tunisia 2011–2012

Messedi, Emna; Fki-Berrajah, Lamia; Gargouri, Saba; Chouikha, Anissa; Chaari, Anis; Bouaziz, Mounir; Jallouli, Hajer; Yahia, Ahlem Ben; Hammami, A; Triki, Henda; Karray-Hakim, Héla

doi:10.1016/j.jcv.2014.07.003

Cited by 17 publications

(7 citation statements)

References 8 publications

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“…However, rubella infection in pregnant women, especially during the first trimester, can result in miscarriages, stillbirths, and congenital rubella syndrome (CRS), a constellation of birth defects that often includes cataracts, hearing loss, mental retardation, and congenital heart defects [ 1 ]. Recently, outbreaks of rubella have reemerged in some countries, such as Italy [ 2 ], Romania [ 3 ], Japan [ 4 ], and Tunisia [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Rubella seroprevalence among pregnant women in Beijing, China

Meng

Luo

et al. 2018

BMC Infect Dis

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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.

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Section: Introductionmentioning

confidence: 99%

Rubella seroprevalence among pregnant women in Beijing, China

Meng

Luo

et al. 2018

BMC Infect Dis

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“…In Tunisia, all known outbreaks of rubella prior to 2011 had been of a strain indigenous to Africa, but during the 2011–2012 outbreak, an imported strain was isolated in several Tunisian cases. With this outbreak, there was a large incidence of neurological symptoms, with 39 of the 280 confirmed cases having encephalitis (Messedi et al, 2014 ). Certain circulating strains today might have more neurotropism.…”

Section: The Global Circulation Of Rubellamentioning

confidence: 99%

Does Rubella Cause Autism: A 2015 Reappraisal?

Hutton

2016

Front. Hum. Neurosci.

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In the 1970s, Stella Chess found a high prevalence of autism in children with congenital rubella syndrome (CRS), 200 times that of the general population at the time. Many researchers quote this fact to add proof to the current theory that maternal infection with immune system activation in pregnancy leads to autism in the offspring. This rubella and autism association is presented with the notion that rubella has been eliminated in today’s world. CRS cases are no longer typically seen; yet, autistic children often share findings of CRS including deafness, congenital heart defects, and to a lesser extent visual changes. Autistic children commonly have hyperactivity and spasticity, as do CRS children. Both autistic and CRS individuals may develop type 1 diabetes as young adults. Neuropathology of CRS infants may reveal cerebral vasculitis with narrowed lumens and cerebral necrosis. Neuroradiological findings of children with CRS show calcifications, periventricular leukomalacia, and dilated perivascular spaces. Neuroradiology of autism has also demonstrated hyperintensities, leukomalacia, and prominent perivascular spaces. PET studies of autistic individuals exhibit decreased perfusion to areas of the brain similarly affected by rubella. In both autism and CRS, certain changes in the brain have implicated the immune system. Several children with autism lack antibodies to rubella, as do children with CRS. These numerous similarities increase the probability of an association between rubella virus and autism. Rubella and autism cross many ethnicities in many countries. Contrary to current belief, rubella has not been eradicated and globally affects up to 5% of pregnant women. Susceptibility continues as vaccines are not given worldwide and are not fully protective. Rubella might still cause autism, even in vaccinated populations.

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“…Gianotti-Crosti syndrome commonly occurs in children and resolves over 3-4 weeks [12][13][14]32,33]. It was initially described in children with hepatitis B infection, but has subsequently been associated with many other viral and bacterial infections [1-14, …”

Section: Gianotti-crosti Syndromementioning

confidence: 99%