RUBELLA: FREQUENCY OF ANTIBODY AMONG CHILDREN AND ADULTS
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Serum specimens from 268 individuals who were in the general population of Montgomery County, Maryland, in 1957 were tested for antibody to rubella and rubeola. The frequency of antibody to rubella increased from approximately 35% among children 1-10 years of age to 85% in the age groups 16-25 years and older. This indicates that approximately 15% of the adults sampled were susceptible to infection with rubella. The major acquisition of rubella antibody occurred among schoolage children and was several years later than that of rubeola antibody. In all age groups the frequency of rubella antibody was consistently less than that for rubeola.Keywords:
Congenital rubella syndrome
Rubella virus
Congenital Rubella
Rubella virus
Congenital rubella syndrome
Congenital Rubella
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A study on the eyes of 39 embryos, which were removed from women who had contracted clinical or subclinical rubella during the first and beginning of the second trimester of gestation is presented. A virological and histological study was performed on the eyes. In four cases rubella virus was isolated from the eye tissues (10.3%) and in nine cases, histological evidence of rubella cataract was found (27.3%). These results suggest that the rubella infection, even in cases of subclinical infections in pregnant women in the first trimester, are highly dangerous (in our study--37.6%) to the eye of the fetus, and, therefore, early diagnosis is necessary in order to avoid the risk of the consequences of congenital rubella infections in the newborn.
Subclinical infection
Rubella virus
Congenital Rubella
Congenital rubella syndrome
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Rubella is a mild febrile rash illness caused by the rubella virus. The most serious consequence of rubella is congenital rubella syndrome (CRS), which occurs if the primary rubella infection occurs during early pregnancy, with subsequent infection of the placenta and the developing fetus.WHO supported countries to set up sentinel surveillance for CRS using standard case definitions, protocols, and case classification scheme. This descriptive analysis summarises the data from 5 countries which have been regularly reporting.A total of 383 suspected cases of CRS were notified from the 5 countries as of December 2016, of which 52 cases were laboratory confirmed and 67 were confirmed on clinical grounds.The majority (43%) of confirmed CRS cases were in the age group 6 - 11 months. The most common major clinical manifestation (Group A) among the confirmed cases is congenital heart disease (72%) followed by cataracts (32%) and glaucoma (10%).The number of years of reporting from these sentinel sites is too short to describe trends in CRS occurrence across the years. However, the limited surveillance data has yielded comparable information with other developing countries prior to introduction of rubella vaccine. As more countries introduce rubella vaccine into their immunisation programs, there is a need to ensure that all rubella outbreaks are thoroughly investigated and documented, to expand sentinel surveillance for CRS in more countries in the Region, and to complement this with retrospective record reviews for CRS cases in selected countries.
Congenital rubella syndrome
Rubella virus
Congenital Rubella
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Abstract Background : Rubella is a mild disease mainly of infants, involving a rash and a fever. However, when women who have no immunity to rubella are infected during the early stage of pregnancy, their babies are often born with congenital rubella syndrome (CRS), which is characterized by a few disorders including deafness, cataracts and heart malformations. To prevent CRS, several strains of live attenuated rubella vaccine have been developed and introduced into immunization programs in many countries. In most Asian countries except Japan, Singapore and Taiwan, rubella remains uncontrolled, and the burden of diseases from CRS is high. In order to develop a control program to reduce the number of CRS cases in Asian countries, it is necessary to conduct a survey of rubella and CRS cases, and to then determine the genotype of the circulating rubella virus in each country. Methods : Cases of rubella and CRS, based on national reporting systems or active surveillance in the Asian countries, are summarized. Sequences of the E1 gene of the virus isolates from the Asian countries were compared by phylogenic analysis. Results : Recent studies of the molecular epidemiology of rubella virus worldwide revealed that there are two genotypes, and that genotype I is circulating almost worldwide, while genotype II is an Asian prototype restricted to the Asian continent. Genotype I viruses fall into a number of groups, some of which are geographically localized. Antigenically these two genotypes are cross‐reactive and immunization with either virus results in immunity to all rubella viruses. Discussion : The hypotheses that rubella virus has evolved on the Asian continent is proposed. The World Health Organization (WHO) has recognized that a rubella immunization program can be combined with the measles immuization program. Inclusion of rubella in the expanded program of immunization (EPI) of measles would be ideal in Asian countries, as it would be efficient and cost effective to administer one injection containing a three‐combined vaccine (MMR). It would also be desirable given that WHO require laboratory tests to confirm the presence of measles or rubella as part of it's measles control project, because rubella is often misdiagnosed as measles.
Rubella virus
Congenital rubella syndrome
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Recent advances have made it possible to isolate rubella virus from affected persons and to propagate the virus in tissue culture. The virus may be identified by the unique cytopathogenic changes in human amnion tissue culture by interference with ECHO virus type 11 in monkey kidney tissue culture. Thus an even closer correlation between an active rubella infection in the mother in the first trimester of pregnancy and the clinical findings of the rubella syndrome is now feasible. The rubella epidemic of 1964 can be expected to produce significant numbers of infants with the congenital rubella syndrome. This paper reports the clinical history of two cases of rubella associated with thrombocytopenia in the newborn.
Rubella virus
Congenital rubella syndrome
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Rubella is an acute infectious disease that normally has a mild clinical course. However, infections during pregnancy, especially before week 12 of gestation (WG), can cause severe birth defects known as congenital rubella syndrome (CRS). The aim of this study was to perform genotyping and molecular characterization of rubella viruses involved in congenital infections in France over the past 15 years (1995 to 2009). Amniotic fluid (AF) specimens (n = 80) from pregnant women with congenital rubella infections (CRI) before week 20 of gestation, and a few other samples available from children/newborns with CRS (n = 26), were analyzed. The coding region of the rubella virus E1 gene was amplified directly from clinical specimens by reverse transcriptase PCR, and the resulting DNA fragments were sequenced. Sequences were assigned to genotypes by phylogenetic analysis with rubella virus reference sequences. Sufficient E1 gene sequences were obtained from 56 cases. Phylogenetic analysis of the sequences showed that at least five different genotypes (1E, 1G, 1B, 2B, and 1h) were present in France and were involved in congenital infections, with a strong predominance of genotype 1E (87%). This is one of the very few comprehensive studies of rubella viruses involved in CRI. The results indicated that over the past 15 years, multiple introductions of the dominant genotype E caused most of the CRI cases in France. A few sporadic cases were due to other genotypes (1B, 1G, 1h, 2B).
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Rubella and congenital rubella syndrome continue to be important health problems worldwide. The detection of rubella RNA directly in clinical specimens is a critical factor in early laboratory diagnosis of recent or congenital infection, in addition to detection of rubella-specific IgM. In order to comply with recent WHO recommendations for establishing uniform genetic analysis protocols for rubella virus we have developed a new block based PCR assay (PCR-E317), which extends the sequence generated by the block based PCR-E592 currently in use, to cover the minimum acceptable 739 nucleotides (nt) window at the E1 gene. In addition, a real-time PCR assay has been developed to allow rapid detection of the virus in the laboratory. The assays were applied to a number of clinical specimens collected from patients including recent rubella incidences in the UK, Ethiopia and Turkey, two prenatal and two congenital rubella syndrome cases. Rubella RNA was detected in specimens from two patients that were collected too early for IgM detection, in two amniotic fluids for prenatal diagnosis and in the follow up specimens from the two infant with congenital rubella syndrome tested for viral secretion. At least four genotypes were identified among these patients. The results showed that molecular assays are important tools in the early diagnosis of rubella and congenital rubella syndrome, in the provision of molecular epidemiological information for tracking transmission pathways and in adding to the knowledge of rubella strain distribution worldwide.
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After vaccination against rubella was introduced, the number of cases of rubella and congenital rubella syndrome decreased significantly. The presentation of a case report of rubella virus congenital infection with important sequellae, stresses the need to reinforce prevention. The existence of rare cases of reinfection imply good surveillance that gestations should be maintained even in women previously immune.
Congenital Rubella
Congenital rubella syndrome
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Abstract Rubella virus is a human virus belonging to the family Togaviridae and the sole member of the rubivirus genus. Rubella virus has a small genome composed of single‐stranded RNA and produces only five proteins. The rubella virus replication cycle takes place entirely within the cytoplasm of the infected cell. Rubella virus establishes a body‐wide or systemic infection that is manifested by mild symptoms including rash, lymph node swelling and low‐grade fever. However, rubella virus is an important human pathogen because it causes a spectrum of serious birth defects known collectively as congenital rubella syndrome (CRS) when a mother lacking immunity is infected during the first trimester of pregnancy. CRS can include blindness, deafness, mental retardation, heart malformations and endocrine dysfunctions. Before development of effective live, attenuated vaccines, rubella virus was the leading teratogenic agent of an infectious nature. Through use of these vaccines, rubella and CRS are controlled in much, but not all, of the world and are targeted for elimination in the Western Hemisphere and Europe. Key Concepts: Rubella virus causes a benign systemic illness characterised by a rash, but is a dangerous teratogen when infection occurs during pregnancy. Fetal infection by rubella virus results in congenital rubella syndrome, a constellation of serious birth defects, particularly deafness, blindness and mental retardation. Rubella virus is classified in the Togaviridae family and is the only member of the rubivirus genus. Rubella virions are pleiomorphic, approximately 70 nm in diameter and consist of a quasispherical capsid containing the genome RNA surrounded by an envelope composed of a lipid bilayer from which protrude glycoprotein spikes. The rubella virus genome is a plus‐polarity RNA, 10 000 nucleotides in length, which encodes only five proteins: P150 and P90, both of which participate in RNA replication in the infected cells, and capsid (C) and envelope glycoproteins 1 and 2 (E1 and E2) which comprise the virion. In the infected cell, rubella virus replication takes place entirely within the cytoplasm. In the infected cell, rubella virus RNA replication, which proceeds through an RNA intermediate, takes place in association with cell membranes. In the infected cell, rubella virion formation takes place in association with the Golgi apparatus and virions are released by exocytosis. Rubella virus isolates worldwide cluster into 13 genotypes that fit into two distinct clades with an overall diversity at the nucleotide level of approximately 10%, a very low level for an RNA virus. Live, attenuated rubella virus vaccines, available since approximately 1970, have been used successfully to control or eliminate rubella in developed countries whereas implementation of these vaccines is progressing, but not complete, in undeveloped countries of the world.
Rubella virus
Congenital rubella syndrome
Togaviridae
Congenital Rubella
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ABSTRACT There is growing evidence for the role of rubella virus in Fuchs' uveitis syndrome (FUS). This report is the first to show persistent intraocular rubella virus in a 28-year-old man with congenital rubella syndrome (CRS), who presented with blurred vision and was diagnosed with FUS.
Congenital rubella syndrome
Rubella virus
Congenital Rubella
Blurred vision
Togaviridae
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