Rubella transmission and the risk of congenital rubella syndrome in Liberia: a need to introduce rubella-containing vaccine in the routine immunization program

Abstract

Background: Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Most African countries including Liberia do not currently provide rubella-containing vaccine (RCV) in their immunization program. We analyzed the existing surveillance data to describe rubella cases and identify the at-risk population. Methods: We conducted a retrospective descriptive statistics on the suspected-measles case-based surveillance data that obtained from the national database. Suspected-measles cases who were negative and indeterminate for measles IgM and tested for rubella IgM were extracted from the database. We used only rubella IgM positive cases to calculate trends and percentages by person, place and time. The cumulative-percent curve was used to visually describe the age distribution of rubella cases. Results: During 2017-2018, a total of 2027 suspected-measles cases with known laboratory results were reported; of which, 1307 were tested for rubella IgM. Among tested cases, 472 (36%) were positive, 769 (59%) were negative and 66 (5%) were indeterminate for rubella IgM. Female contributed 269 (57%) of the confirmed rubella cases respectively. The median age was 7 years with an interquartile range of 5-10 years. From the total rubella cases, 6 (1%) were under 1 year, 109 (23%) were 1-4 years, 207 (44%) were 5-9 years, 87 (18%) were 10-14 years and 56 (12%) were more than or equal to 15 years. Women in their reproductive-age contributed 23 (5%) of rubella cases with 17% positivity rate. Two-thirds or 307 (65%) of the cases were reported from February to May which is dry season in Liberia.

Rubella epidemiology in the Central African Republic, 2015-2016 and molecular characterization of virus strains from 2008-2016

“…Rubella cases identified in the context of measles surveillance between 2007 and 2014 (Farra et al, 2016), but also in the present study looking at 2015 and 2016 data showed an annual seasonal pattern, with peak incidences during the dry season between January and March. An increased incidence of rubella during the dry season was documented in basically all parts of Africa (Chimhuya et al, 2015, Getahun et al, 2016, Kadjo et al, 2018, Nimpa Mengouo et al, 2017, Omoleke and Udenenwu, 2016, Woyessa et al, 2019 and as suggested in a study done in Beijing is probably associated with meteorological variables, such as temperature and relative humidity (Zhang et al, 2019).…”

Pregnancy and viral infections: Mechanisms of fetal damage, diagnosis and prevention of neonatal adverse outcomes from cytomegalovirus to SARS-CoV-2 and Zika virus

“…Transmission usually occurs through respiratory droplets but can also occur to the fetus through placenta. Vertical transmission of rubella is higher in the first weeks of gestation, leading to miscarriage, stillbirth, or a chronic injury of several organs in the fetus, well-known as Congenital rubella syndrome (CRS), with the classical fetal Gregg's triad of congenital cataracts, deafness, and cardiac defects [ 88 ]. Mechanisms of fetal damage …”

Estimation of Rubella virus antibodies among aborted women in Ibb City-Yemen

“…It is an RNA virus that belongs to the Rubivirus genus and Matonavirida family. [1][2][3][4] It is an infectious disease transmitted through respiratory droplets from person to person or through placenta from mother to her fetus. [3][4][5][6] The average incubation period is 14 days and a range of 12-23 days.…”

“…[1][2][3][4] It is an infectious disease transmitted through respiratory droplets from person to person or through placenta from mother to her fetus. [3][4][5][6] The average incubation period is 14 days and a range of 12-23 days. The first symptom is a maculopapular rash, which appears on the face and then extends to the body surface, lasting almost three days.…”