Changing Epidemiology of Congenital Rubella Syndrome in the United States

Schluter, W. William; Reef, Susan E.; Redd, Stephen C.; Dykewicz, Clare A.

doi:10.1086/515384

Cited by 54 publications

(12 citation statements)

References 35 publications

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“…Other common signs were cataract (8 children; 44%), purpura (6 children; 33%) and splenomegaly (6 children; 33%). The proportions of various CRS signs and symptoms identified in Myanmar are similar to those reported in studies from Mexico, 19 Panama 20 and the United States, 21 although surveillance methods varied among studies (Table 4). The proportion of children who were deaf was lower in Myanmar and Mexico but this most likely relates to the younger age at which children were examined and the limited ability to assess hearing loss in very young children in most developing countries.…”

Section: Discussionsupporting

confidence: 71%

Active surveillance for congenital rubella syndrome in Yangon, Myanmar

Thant

Myint

et al. 2004

Bull World Health Organ

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Objective Rubella vaccine is not included in the immunization schedule in Myanmar. Although surveillance for outbreaks of measles and rubella is conducted nationwide, there is no routine surveillance for congenital rubella syndrome (CRS). Therefore, we organized a study to assess the burden of CRS. Methods From 1 December 2000 to 31 December 2002 active surveillance for CRS was conducted among children aged 0-17 months at 13 hospitals and 2 private clinics in Yangon, the capital city. Children with suspected CRS had a standard examination and a blood sample was obtained. All serum samples were tested for rubella-specific IgM; selected samples were tested for rubellaspecific IgG and for rubella RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Findings A total of 81 children aged 0-17 months were suspected of having CRS. Of these, 18 children had laboratory-confirmed CRS (7 were IgM positive; 7 were RT-PCR positive; and 10 were IgG positive at > 6 months of age). One additional child who tested positive by RT-PCR and whose mother had had rubella during pregnancy but who had a normal clinical examination was classified as having congenital rubella infection. During 2001-02 no rubella outbreaks were detected in Yangon Division. In the 31 urban townships of Yangon Division, the annual incidence was 0.1 laboratory-confirmed cases of CRS per 1000 live births. Conclusion This is the first population-based study of CRS incidence from a developing country during a rubella-endemic period; the incidence of CRS is similar to endemic rates found in industrialized countries during the pre-vaccine era. Rubella-specific IgG tests proved practical for diagnosing CRS in children aged > 6 months. This is one of the first studies to report on the use of rubellaspecific RT-PCR directly on serum samples; further studies are warranted to confirm the utility of this method as an additional means of diagnosing CRS. Voir page 18 le résumé en français. En la página 18 figura un resumen en español. Keywords

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Section: Discussionsupporting

confidence: 71%

Active surveillance for congenital rubella syndrome in Yangon, Myanmar

Thant

Myint

et al. 2004

Bull World Health Organ

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“…1,7 Constatamos em nosso estudo que a rubéola congênita correspondeu a 23,6% dos casos e foi a causa identificável mais expressiva de deficiência auditiva, confirmando estudos já realizados nos países em desenvolvimento. 5,[8][9][10][11] Outras etiologias relevantes foram associações de fatores patogênicos (19,8%) como descritos na Tabela 2 e a meningite foi a etiologia pós-natal mais importante de disacusia sensorioneural. (Tabela 1) A incidência de meningite na literatura varia de 6 a 22%.…”

Section: Resultsunclassified

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Cecatto

Garcia

Costa

et al. 2003

Rev. Bras. Otorrinolaringol.

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Obj etivo: Determinar as principais etiologias de deficiência auditiva em estudantes da Escola de Ensino Especial para surdos "Anne Sullivan" em São Caetano do Sul e comparar com os dados da literatura mundial. Forma de estudo: Estudo retrospectivo Material e método: Cento e trinta e um alunos da escola no ano de 2001 foram avaliados através de análise de seus prontuários, levando-se em conta dados de anamnese com a família, exame físico otorrinolaringológi-co, avaliação fonoaudiológica e psicológica. Resultados: Dos 131 pacientes, 67 (51%) eram do sexo masculino e 64 (49%) do sexo feminino. A perda auditiva sensorioneural foi a mais encontrada, representando 99% dos casos. Quanto ao grau de disacusia, 65% foi classificado como profundo. Quanto à etiologia, 24% foi classificada como desconhecida e das causas identificáveis a rubéola congênita foi a mais encontrada (22%). Na maioria dos pacientes a suspeita e o diagnóstico foram feitos com 12 meses de idade. Conclusões: A etiologia não definida foi a mais representativa, seguida pela rubéola, e a idade de diagnóstico predominou entre 12 e 30 meses. Aim:The purpose of this study was to determine the etiology of hearing loss in students of "Escola de Ensino Especial Anne Sullivan" at São Caetano do Sul to make a comparison of the results with the literature. Study design: Retrospective study. Material and method: We analyzed the medical history of 131 students in 2001, including the familiar anamnesis, otorhinolaryngological, psychological and audiological examination. Results: In the group, 67 (51%) were males and 64 (49%) females; 99% showed sensorineural hearing loss, 65% classified as profound. Etiological factors: in 24% no cause of hearing impairment could be determined; rubella was found in 22% of the children. The majority of the children had the suspicion and the diagnosis within 12 months old. Conclusions: The undefined etiology was the main finding, followed by congenital rubella. The diagnosis has to be made between 12 and 30 months. Rev Bras Otorrinolaringol. V.69, n.2, 235-40, mar./abr. 2003 ORIGINAL ARTICLE ARTIGO ORIGINAL «« ««Palavras-chave: perda auditiva, surdez, infância, etiologia.

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“…A study in the United States showed that among cases of CRS with missed opportunities for vaccination (including postpartum, premarital, and occupational opportunities), 81% missed postpartum opportunities. 33 To achieve the goal of eradicating rubella, all opportunities of vaccination should be taken to ensure that all susceptible women are vaccinated.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of rubella among women of childbearing age in Taiwan after nationwide vaccination.

Guo²

2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. Taiwan initiated a nationwide program in 1986 to have all 15-year-old schoolgirls vaccinated against rubella and another program in 1992 to encourage all women of childbearing age to receive rubella vaccination. To assess the immunity among women after the implementation of these programs, we conduct a serosurvey. We recruited women who were 15-44 years old and received pre-employment health examinations at the clinic of an industrial park from January 1 to June 30, 2000. Anti-rubella antibody titers were determined by enzyme-linked immunoassays. All 1,087 women who fit the selection criteria agreed to participate, and the overall susceptible (seronegative) rate was 5.7%. The susceptible rate was much lower among women who were covered by both programs than women who were not (4% versus 23%, P < 0.001). The nationwide vaccination programs were effective, but a substantial proportion of childbearing-age women were still susceptible and need booster vaccination.

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Changing Epidemiology of Congenital Rubella Syndrome in the United States

Cited by 54 publications

References 35 publications

Active surveillance for congenital rubella syndrome in Yangon, Myanmar

Active surveillance for congenital rubella syndrome in Yangon, Myanmar

Análise das principais etiologias de deficiência auditiva em Escola Especial "Anne Sullivan"

Seroprevalence of rubella among women of childbearing age in Taiwan after nationwide vaccination.

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