Strategies for elimination of rubella in pregnancy and of congenital rubella syndrome in high and upper-middle income countries

Terracciano, Elisa; Amadori, Fabiana; Pettinicchio, Valentina; Zaratti, Laura; Franco, Elisabetta

doi:10.15167/2421-4248/jpmh2020.61.1.1310

Cited by 5 publications

(6 citation statements)

References 63 publications

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“…Therefore, administration of an additional dose is not recommended. Conversely, this recommendation cannot be extended to female healthcare operators because of the low risk of CRS following breakthrough infection during pregnancy [20,26,27]. These workers are considered to be at a higher risk of infection than the general population due to their work activities involving close contact with potentially infected patients.…”

Section: Discussionmentioning

confidence: 99%

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings

Ferrari,

Somma,

Gentili

et al. 2023

Healthcare

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Background: Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting. Aims: To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine. Methods: We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL. Results: The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis (p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%). Conclusions: Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators.

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Section: Discussionmentioning

confidence: 99%

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings

Ferrari,

Somma,

Gentili

et al. 2023

Healthcare

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“…Secondly, many cases may not be detected and/or reported by the surveillance system perhaps due to the asymptomatic nature of rubella infection in mothers, the rarity and subtle nature of CRS symptoms in infants and children, some clinical manifestations may not be present at birth or only present later in life, (e.g. deafness or mental retardation), only severe cases may be diagnosed [ 23 , 31 ]. Additionally, as CRS sentinel site surveillance is not yet part of the national rash surveillance system, it was not designed to capture all cases, but rather to monitor trends and form a recent baseline for CRS in South Africa.…”

Section: Discussionmentioning

confidence: 99%

A retrospective 5-year review of rubella in South Africa prior to the introduction of a rubella-containing vaccine

et al. 2022

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South Africa has yet to introduce a rubella-containing vaccine (RCV) into its Expanded Programme on Immunisation (EPI). Here we evaluated the incidence of laboratory-confirmed rubella and congenital rubella syndrome (CRS) cases over the years 2015 to 2019, to document the epidemiology of rubella and CRS within South Africa prior to a RCV introduction. This retrospective study evaluated the number of laboratory-confirmed rubella cases reported through the national febrile rash surveillance system. A positive test for rubella immunoglobulin M (IgM) antibodies was considered a confirmed rubella case. For CRS cases, we reported laboratory-confirmed CRS cases collected from 28 sentinel-sites from all nine provinces of South Africa. From 2015–2019, 19 773 serum samples were tested for rubella IgM antibodies, 6 643 (33.6%) were confirmed rubella cases. Rubella was seasonal, with peaks in spring (September to November). Case numbers were similar between males (n = 3 239; 50.1%) and females (n = 3 232; 49.9%). The highest burden of cases occurred in 2017 (n = 2 526; 38%). The median age was 5 years (IQR: 3–7 years). Importantly, of females with rubella, 5.0% (161 of 3 232) of the cases were among women of reproductive age (15–44 years). A total of 62 CRS cases were reported, the mortality rate was 12.9% (n = 8), and the most common birth defect was congenital heart disease. In conclusion, rubella is endemic in South Africa. Children below the age of 10 years were the most affected, however, rubella was also reported among women of reproductive age. The baseline data represented here provides insight into the burden of rubella and CRS in South Africa prior to the introduction of a RCV, and can enable planning of RCV introduction into the South African EPI.

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“…1 ) and genus Rubivirus ( Das and Kielian, 2021 ). This virus can cause an acute infection characterized by mild symptoms, such as rash and fever ( TERRACCIANO et al, 2020 ). The incubation period ranges from 12 to 23 days ( Best, 2007 ).…”

Section: Exanthematous Viral Infectionsmentioning

confidence: 99%

“…Rubella is an airborne disease that infects children, adults, and pregnant women, and it is easily transmitted through breathing droplets or contact with respiratory secretions ( Winter and Moss, 2022 ). When the infection occurs during the first trimester of pregnancy, it can cause fetal death or congenital rubella syndrome (CRS) ( Table 1 ), which is known to affect four babies out of every one thousand live births ( TERRACCIANO et al, 2020 ). This syndrome causes serious lifelong clinical symptoms including heart defects, cataracts, hearing impairments, jaundice, hepatosplenomegaly, and microcephaly ( Winter and Moss, 2022 ), in addition to thyroid dysfunction and diabetes ( TERRACCIANO et al, 2020 ).…”

Section: Exanthematous Viral Infectionsmentioning

confidence: 99%

“…When the infection occurs during the first trimester of pregnancy, it can cause fetal death or congenital rubella syndrome (CRS) ( Table 1 ), which is known to affect four babies out of every one thousand live births ( TERRACCIANO et al, 2020 ). This syndrome causes serious lifelong clinical symptoms including heart defects, cataracts, hearing impairments, jaundice, hepatosplenomegaly, and microcephaly ( Winter and Moss, 2022 ), in addition to thyroid dysfunction and diabetes ( TERRACCIANO et al, 2020 ). In 1969, rubella-containing vaccines (RCVs) were introduced in Europe and the United States, which played a vital role in reducing rubella and CRS infections ( Motaze et al, 2021 ).…”

Section: Exanthematous Viral Infectionsmentioning

confidence: 99%

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Epidemiologic and clinical updates on viral infections in Saudi Arabia

Alshiban,

Aleyiydi,

Nassar

et al. 2024

Saudi Pharmaceutical Journal

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Strategies for elimination of rubella in pregnancy and of congenital rubella syndrome in high and upper-middle income countries

Cited by 5 publications

References 63 publications

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings

Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings

A retrospective 5-year review of rubella in South Africa prior to the introduction of a rubella-containing vaccine

Epidemiologic and clinical updates on viral infections in Saudi Arabia

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