Outbreak of rubella after mass vaccination of children and adult women: challenges for rubella elimination strategies

Menegolla, Ivone Andreatta; Bercini, Marilina; Schermann, Maria Tereza; Nunes, Zenaida Marion Alves; Segatto, Teresa Cristina Vieira; Siqueira, Marilda Mendonça; Flannery, Brendan

doi:10.1590/s1020-49892011000400005

Cited by 9 publications

(2 citation statements)

References 15 publications

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“…7 During the last few years, many countries have reported outbreaks of rubella infection. 11,12 However, to our knowledge, available data in the literature dealing with rubella encephalitis are scarce and are limited to several case reports. 9,13 Tunisian public health care authorities reported in 2011 an important increase of patients admitted to hospitals because of eruptive fever.…”

Section: Discussionmentioning

confidence: 99%

Childhood Rubella Encephalitis

et al. 2012

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We to report clinical biological and radiologic features of rubella encephalitis in childhood and assess its prognostic impact. Our retrospective study was conducted in an intensive care unit of a university hospital in Sfax, Tunisia. Twenty-one children (age range, 1-15 years) were included. Median age was 9 years (lower and upper quartiles, 7-11 years). On admission, generalized maculopapular eruption was found in 17 cases (81%). Median Glasgow Coma Scale score was 7 (lower and upper quartiles, 7-8). Twenty patients (95.2%) experienced at least 1 episode of seizures. Sixteen patients (76.2%) developed a status epilepticus. The result for enzyme-linked immunosorbent assay detecting anti-rubella immunoglobulin (M) was positive in the serum and in the cerebrospinal fluid samples for all our patients. Magnetic resonance imaging (MRI) of the brain was performed on admission for 3 patients (14.3%) and within a median of 4 days (lower and upper quartiles, 2-6 days) for 8 patients. The test was normal in 6 cases. Two deaths were recorded (9.5%). Survivors had no neurological sequelae 6 months after intensive care unit discharge.

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Section: Discussionmentioning

confidence: 99%

Childhood Rubella Encephalitis

et al. 2012

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“…24 Combined vaccination strategy with a risk population approach for adults (WCBA, college students, health care workers, teachers, military personnel, government employees, and industry employees) and universal vaccination for boys and girls could be more efficient in reducing the incidence of acquired rubella and CRS as observed in Brazil, the US, and Cuba. [26][27][28][29] The review concluded that a combined vaccination strategy with routine vaccination for boys and girls and universal vaccination for adolescents and adults (both men and women), aged 15-39 years, through "speed-up" campaigns, was the most effective strategy. 22 This strategy reduced rubella incidence by more than 98%, and no CRS was reported since 2008 in Mexico and Costa Rica.…”

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confidence: 99%

Rubella seroprevalence among mothers and incidence of congenital rubella three years after rubella vaccine introduction in Vietnam

Toizumi

Tanaka

Moriuchi

et al. 2021

Human Vaccines & Immunotherapeutics

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Following a rubella outbreak in 2011, Vietnam implemented a mass measles-rubella vaccination campaign for children aged 1-14 years in 2014-2015, further expanding the target age to 16-17 years in 2016; routine vaccination was introduced in 2014. However, there was concern that a substantial proportion of women of child-bearing age were still susceptible to rubella, with the fear of congenital rubella emergence. Thus, we conducted a prospective cohort study in Nha Trang, Vietnam, from 2017-2018 to investigate pregnant women's susceptibility to rubella infection, the incidence of congenital rubella infection, and factors associated with susceptibility. Cord blood was tested for rubella-specific immunoglobulin M (IgM) and IgG; neonatal saliva and cord blood specimens were examined for rubella-RNA. We analyzed 2013 mother-baby pairs. No baby was rubella-IgM or rubella-RNA positive. Overall, 20.4% of mothers were seronegative (95% confidence interval, 18.6%-22.1%). The seronegativity was significantly low among mothers aged <35 years. We found that maternal age groups of 20-24 and 25-29 years, and the lack of self-reported vaccination history were significantly associated with seronegativity. Many pregnant women who were not covered by the vaccination campaign are still at risk of rubella infection.

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