Seroprevalence and incidence of rubella in and around Delhi (1988-2002)

Abstract

National Institute of Communicable Diseases (NICD) has been engaged in rubella testing for serodiagnosis of the infection and screening for immunity status. The compiled and evaluated data of the work done on rubella testing for the past fifteen years has been presented here to show the trend and changing scenario of the disease in Delhi. Blood samples were from 7424 patients referred to NICD, Delhi for serodiagnosis of congenital Rubella syndrome (CRS) in malformed babies, in utero rubella infection in women and immunity status of pregnant women and women with bad obstetric history. They were tested for rubella IgG and/or rubella IgM antibodies using commercially available reagents and kits. The data from the 15 years of testing was then compiled and evaluated. From the available data it was seen that immunity status against rubella in childbearing age group of women increased steadily from 49% in 1988 to 87% in 2002. Reported cases of CRS at NICD are also on the decline over the time period. There is periodic indication of high incidence of rubella in the year 1988; 1991and 1998 as the reported cases of acute rubella infection in childbearing age group is high during these years. Key words: Rubella virus, congenital rubella syndrome, serosurveillance, immunity status, in utero infection*Corresponding author Microbiology Division, National Institute of Communicable Diseases, New Delhi -110 054, India. Received: 09-07-200409-07- Accepted: 08-04-2005 Primary maternal rubella virus infection during the first trimester of pregnancy carries a high risk for the development of the congenital rubella syndrome (CRS) with characteristic malformations of the heart, eye and ear. [1][2][3][4][5][6][7] Although rubella vaccination has reduced the incidence of rubella virus substantially; WHO estimates that worldwide more than 100, 000 children are born with CRS each year, most of them in developing countries. 8A major section of women are immune by the time they reach childbearing age from childhood exposure to rubella virus infection.9-12 However, periodic epidemics occur among children and spread to involve the small portion of susceptible adult women, leading to epidemics of CRS. 8,[13][14][15] Infants with CRS shed rubella virus for long periods in nasopharyngeal secretions and in urine and trasmit rubella infection to close contacts. 8 Findings accumulated in the present study are from 15 years of rubella testing at NICD as per WHO guidelines for surveillance of CRS and prevalence of rubella in the recent past. 16 Materials and MethodsThe evaluated data covers the period of 15 years (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002) during which 7484 blood samples were referred from Delhi based government hospitals and maternity centers to virology laboratory of Microbiology division at NICD, for serodiagnosis of rubella virus infection and/or immunity status against rubella infection. The samples belonged to patients from the following clinical groups.1. Congenital malf...

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