The Experts below are selected from a list of 19395 Experts worldwide ranked by ideXlab platform
Norio Ohmagari - One of the best experts on this subject based on the ideXlab platform.
-
conjunctivitis the key clinical characteristic of adult Rubella in japan during two large outbreaks 2012 2013 and 2018 2019
PLOS ONE, 2020Co-Authors: Hidetoshi Nomoto, Masahiro Ishikane, Takato Nakamoto, Masayuki Ohta, Shinichiro Morioka, Kei Yamamoto, Satoshi Kutsuna, Shunsuke Tezuka, Junwa Kunimatsu, Norio OhmagariAbstract:Background: Rubella virus infection mainly causes illness with mild fever, rash, and lymphadenopathy in children; however, the clinical characteristics of adult Rubella are not well-known. Methods: An observational study was conducted to compare the characteristics between adult Rubella and adult non-Rubella among participants aged ≥18 years, with suspected symptomatic Rubella. Participants were screened for Rubella-specific IgM expression using an enzyme immune assay kit, at a tertiary care hospital in Japan during two outbreaks (January 2012–December 2013 and January 2018–March 2019). Adult Rubella diagnosis followed strong positive or paired Rubella-specific IgM expression or positive Rubella-specific reverse-transcription-polymerase chain reaction. Patients aged
-
conjunctivitis the key clinical characteristic of adult Rubella in japan during two large outbreaks 2012 2013 and 2018 2019
PLOS ONE, 2020Co-Authors: Hidetoshi Nomoto, Masahiro Ishikane, Takato Nakamoto, Masayuki Ohta, Shinichiro Morioka, Kei Yamamoto, Satoshi Kutsuna, Shunsuke Tezuka, Junwa Kunimatsu, Norio OhmagariAbstract:Background Rubella virus infection mainly causes illness with mild fever, rash, and lymphadenopathy in children; however, the clinical characteristics of adult Rubella are not well-known. Methods An observational study was conducted to compare the characteristics between adult Rubella and adult non-Rubella among participants aged ≥18 years, with suspected symptomatic Rubella. Participants were screened for Rubella-specific IgM expression using an enzyme immune assay kit, at a tertiary care hospital in Japan during two outbreaks (January 2012–December 2013 and January 2018–March 2019). Adult Rubella diagnosis followed strong positive or paired Rubella-specific IgM expression or positive Rubella-specific reverse-transcription-polymerase chain reaction. Patients aged <18 years or with clinically suspected Rubella with weak or negative IgM expression were excluded. Results Overall, 82 adult Rubella and 139 adult non-Rubella, with a median age (interquartile range) of 31 (25–41) years and 34 (27–42) years, respectively, were included. Multivariate analysis showed that conjunctivitis (odds ratio 80.6; 95% confidence interval 13.4–486.3; P <0.001) and male sex (odds ratio 7.1; 95% confidence interval 1.8–28.1; P = 0.005) were significantly associated with adult Rubella. Among men born from 1962 to 1979 (high-risk population, n = 68), conjunctivitis also showed a significant association with adult Rubella in the multivariate analysis (odds ratio 24.2; 95% confidence interval 1.1–553.7; P = 0.046) as these patients were not included in the national vaccination program. There was no difference in the clinical characteristics between one-time vaccination (n = 11) and no vaccination (n = 8) patient in the adult Rubella group. Conclusions Conjunctivitis was the key clinical symptom associated with adult Rubella. For the early diagnosis of adult Rubella, clinicians should focus on assessing conjunctivitis in patients.
Joseph P Icenogle - One of the best experts on this subject based on the ideXlab platform.
-
seroprevalence of Rubella virus antibodies among pregnant women in the center and south west regions of cameroon
PLOS ONE, 2019Co-Authors: Nadesh Ashukem Taku, Joseph P Icenogle, Valantine Ngum Ndze, Emily Abernathy, Lijuan Hao, Diane Wakukouomou, Samuel Wanji, Janefrancis K T AkoachereAbstract:Rubella infection in early pregnancy can lead to miscarriages, fetal death, or birth of an infant with congenital Rubella syndrome (CRS). In Cameroon, like in many developing countries, Rubella surveillance is not well-established. The aim of this study was to determine the prevalence of Rubella virus specific antibodies among pregnant Cameroonians. We conducted a cross-sectional study for Rubella infection among pregnant women attending antenatal clinics in the Center and South-West regions of Cameroon. Demographic data and blood were collected and tested for Rubella specific antibodies (IgG and IgM), and for the IgM positive cases, IgG avidity and real time PCR was done. From December 2015 to July 2017, 522 serum samples were collected and tested from pregnant women. The seroprevalence of Rubella specific IgG was 94.4%, presumably due to immunity induced by wild-type Rubella virus. The seroprevalence of Rubella specific IgM was 5.0%, possibly indicating Rubella infection. However, IgG avidity testing of the IgM positive cases detected high avidity IgGs, ranging from 52.37% to 87.70%, indicating past Rubella infection. 5.6% (29/522) of the participants had negative results for IgG to Rubella virus, indicating susceptibility to Rubella infection. None of the participants had received a Rubella containing vaccine (RCV), but 51% (266/522) of the pregnant women lived in a house with a child with records of at least one dose of RCV. Rubella virus RNA was not detected in the urine of any IgM positive case. Findings from this study show that Rubella infection is significant in Cameroon. Some pregnant women are still susceptible to Rubella infection. For a better management of Rubella infection in pregnancy in Cameroon, consideration should be taken to investigate for IgG-avidity test in cases with positive Rubella IgM result to distinguish between recent from past Rubella infection.
-
genotypes of Rubella virus and the epidemiology of Rubella infections in the democratic republic of the congo 2004 2013
Journal of Medical Virology, 2016Co-Authors: Elizabeth Pukuta, Joseph P Icenogle, Emily Abernathy, Diane Wakukouomou, Benoit Kebela Illunga, Ricardo Obama, Vital Mondonge, Benjamin A Dahl, Balcha G Maresha, Jeanjacques MuyembeAbstract:Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital Rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of Rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of Rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for Rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for Rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for Rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of Rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC Rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of Rubella virus circulating in the DRC. These data contribute to a better understanding of Rubella burden and the dynamics of Rubella virus circulation in Africa. Efforts to establish Rubella surveillance in the DRC are needed to support Rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc.
-
genomic characterization of a persistent Rubella virus from a case of fuch uveitis syndrome in a 73 year old man
Journal of Clinical Virology, 2015Co-Authors: Emily Abernathy, Joseph P Icenogle, Min-hsin Chen, Randall R Peairs, Hassan NamdariAbstract:Abstract Background Many cases of Fuchs’ uveitis have been associated with persistent Rubella virus infection. A 73-year-old male patient with typical Fuchs’ Uveitis Syndrome (FUS) first experienced heterochromia of the left eye at the age fourteen, when Rubella was endemic in the US. Objectives The purposes of this report are to describe the patient’s FUS clinical presentations and to characterize the virus detected in the vitreous fluid. Study design The patient underwent a therapeutic pars plana vitrectomy in May 2013. A real-time RT-PCR assay for Rubella virus was performed on the vitreous fluid by Focus Diagnostics. Additional real-time RT-PCR assays for Rubella virus detection and RT-PCR assays for generation of templates for sequencing were performed at the Centers for Disease Control and Prevention (CDC). Results The results from Focus Diagnostics were positive for Rubella virus RNA. Real-time RT-PCR assays at CDC were also positive for Rubella virus. A Rubella virus sequence of 739 nucleotides was determined and phylogenetic analysis showed that the virus was the sole member of a new phylogenetic group when compared to reference virus sequences. Conclusions While FUS remains a clinical diagnosis, findings in this case support the association between Rubella virus and the disease. Phylogenetic analysis provided evidence that this Rubella virus was likely a previously undetected genotype which is no longer circulating. Since the patient had Rubella prior to 1955, this sequence is from the earliest Rubella virus yet characterized.
-
elimination of endemic measles Rubella and congenital Rubella syndrome from the western hemisphere the us experience
JAMA Pediatrics, 2014Co-Authors: Mark J Papania, Joseph P Icenogle, Susan E Reef, Susan B Redd, Emily Abernathy, Gregory S Wallace, Paul A Rota, Amy Parker Fiebelkorn, Gregory L Armstrong, Albert E BarskeyAbstract:Importance To verify the elimination of endemic measles, Rubella, and congenital Rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic Rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, Rubella, and CRS had been sustained. Objective To review the evidence for sustained elimination of endemic measles, Rubella, and CRS from the United States through 2011. Design, Setting, and Participants Review of data for measles from 2001 to 2011 and for Rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. Main Outcomes and Measures Annual numbers of measles, Rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and Rubella; and measles-mumps-Rubella vaccination coverage levels. Results Since 2001, US reported measles incidence has remained below 1 case per 1 000 000 population. Since 2004, Rubella incidence has been below 1 case per 10 000 000 population, and CRS incidence has been below 1 case per 5 000 000 births. Eighty-eight percent of measles cases and 54% of Rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or Rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and Rubella. Conclusions and Relevance The external expert panel concluded that the elimination of endemic measles, Rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or Rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
-
enhanced laboratory surveillance for the elimination of Rubella and congenital Rubella syndrome in the americas
The Journal of Infectious Diseases, 2011Co-Authors: Joseph P Icenogle, Cuauhtemoc Ruiz Matus, Ana Maria Bispo De Filippis, Jon Kim AndrusAbstract:One of the reasons the 1997 Technical Advisory Group on Vaccine-Preventable Diseases recommended acceleration of Rubella and congenital Rubella syndrome (CRS) prevention efforts was the fact that the enhanced measles surveillance system in the Americas found that 25% of reported measles cases were laboratory-confirmed Rubella cases. Until 1997, the laboratory network primarily focused on measles diagnosis. Since 1999, due to the accelerated Rubella control and CRS prevention strategy, laboratories have supported the regional measles, Rubella, and CRS elimination goals. The measles-Rubella laboratory network established in the Americas provides timely confirmation or rejection of suspected measles and Rubella cases, and determination of the genotypic characteristics of circulating virus strains, critical information for the programs. A quality assurance process has ensured high-quality performance of procedures in the network. Challenges are occurring, but the measles-Rubella laboratory network continues to adapt as the requirements of the program change, demonstrating the high quality of the laboratories in support of public health activities and elimination goals.
Susan E Reef - One of the best experts on this subject based on the ideXlab platform.
-
progress toward Rubella and congenital Rubella syndrome control south east asia region 2000 2016
Morbidity and Mortality Weekly Report, 2018Co-Authors: Sudhir Khanal, Susan E Reef, Alya Dabbagh, Katrina Kretsinger, Sunil Bahl, Mohammad Sharifuzzaman, Deepak Dhongde, Sirima Pattamadilok, Michelle Morales, Minal K PatelAbstract:In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR)* adopted the goal of elimination of measles and control† of Rubella and congenital Rubella syndrome (CRS) by 2020 (1). Rubella is the leading vaccine-preventable cause of birth defects. Although Rubella typically causes a mild fever and rash in children and adults, Rubella virus infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, or a constellation of congenital malformations known as CRS, commonly including visual, auditory, and/or cardiac defects, and developmental delay (2). Rubella and CRS control capitalizes on the momentum created by pursuing measles elimination because the efforts are programmatically linked. Rubella-containing vaccine (RCV) is administered as a combined measles and Rubella vaccine, and Rubella cases are detected through case-based surveillance for measles or fever and rash illness (3). This report summarizes progress toward Rubella and CRS control in SEAR during 2000-2016. Estimated coverage with a first RCV dose (RCV1) increased from 3% of the birth cohort in 2000 to 15% in 2016 because of RCV introduction in six countries. RCV1 coverage is expected to increase rapidly with the phased introduction of RCV in India and Indonesia beginning in 2017; these countries are home to 83% of the SEAR birth cohort. During 2000-2016, approximately 83 million persons were vaccinated through 13 supplemental immunization activities (SIAs) conducted in eight countries. During 2010-2016, reported Rubella incidence decreased by 37%, from 8.6 to 5.4 cases per 1 million population, and four countries (Bangladesh, Maldives, Sri Lanka, and Thailand) reported a decrease in incidence of ≥95% since 2010. To achieve Rubella and CRS control in SEAR, sustained investment to increase routine RCV coverage, periodic high-quality SIAs to close immunity gaps, and strengthened Rubella and CRS surveillance are needed.
-
progress toward Rubella and congenital Rubella syndrome control and elimination worldwide 2000 2018
Morbidity and Mortality Weekly Report, 2017Co-Authors: Gavin B Grant, Shalini Desai, Laure Dumolard, Katrina Kretsinger, Susan E ReefAbstract:Rubella is a leading cause of vaccine-preventable birth defects. Although Rubella virus infection usually causes a mild febrile rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital Rubella syndrome (CRS). A single dose of Rubella-containing vaccine (RCV) can provide lifelong protection (1). In 2011, the World Health Organization (WHO) updated guidance on the use of RCV and recommended capitalizing on the accelerated measles elimination activities as an opportunity to introduce RCV (1). The Global Vaccine Action Plan 2011-2020 (GVAP) includes a target to achieve elimination of Rubella in at least five of the six WHO regions by 2020 (2). This report on the progress toward Rubella and CRS control and elimination updates the 2017 report (3), summarizing global progress toward the control and elimination of Rubella and CRS from 2000 (the initiation of accelerated measles control activities) and 2012 (the initiation of accelerated Rubella control activities) to 2018 (the most recent data) using WHO immunization and surveillance data. Among WHO Member States,* the number with RCV in their immunization schedules has increased from 99 (52% of 191) in 2000 to 168 (87% of 194) in 2018†; 69% of the world's infants were vaccinated against Rubella in 2018. Rubella elimination has been verified in 81 (42%) countries. To make further progress to control and eliminate Rubella, and to reduce the equity gap, introduction of RCV in all countries is important. Likewise, countries that have introduced RCV can achieve and maintain elimination with high vaccination coverage and surveillance for Rubella and CRS. The two WHO regions that have not established an elimination goal (African [AFR] and Eastern Mediterranean [EMR]) should consider establishing a goal.§.
-
characterization of the risks of adverse outcomes following Rubella infection in pregnancy
Risk Analysis, 2016Co-Authors: Kimberly M Thompson, Susan E Reef, Emily A Simons, Kamran Badizadegan, Louis Z CooperAbstract:Although most infections with the Rubella virus result in relatively minor sequelae, Rubella infection in early pregnancy may lead to severe adverse outcomes for the fetus. First recognized in 1941, congenital Rubella syndrome (CRS) can manifest with a diverse range of symptoms, including congenital cataracts, glaucoma, and cardiac defects, as well as hearing and intellectual disability. The gestational age of the fetus at the time of the maternal Rubella infection impacts the probability and severity of outcomes, with infection in early pregnancy increasing the risks of spontaneous termination (miscarriage), fetal death (stillbirth), birth defects, and reduced survival for live-born infants. Rubella vaccination continues to change the epidemiology of Rubella and CRS globally, but no models currently exist to evaluate the economic benefits of Rubella management. This systematic review provides an overall assessment of the weight of the evidence for the outcomes associated with Rubella infections in the first 20 weeks of pregnancy. We identified, evaluated, and graded 31 studies (all from developed countries) that reported on the pregnancy outcomes of at least 30 maternal Rubella infections. We used the available evidence to estimate the increased risks of spontaneous termination, fetal death, infant death, and CRS as a function of the timing of Rubella infection in pregnancy and decisions about induced termination. These data support the characterization of the disability-adjusted life years for outcomes associated with Rubella infection in pregnancy. We find significant impacts associated with maternal Rubella infections in early pregnancy, which economic analyses will miss if they only focus on live births of CRS cases. Our estimates of fetal loss from increased induced terminations due to maternal Rubella infections provide context that may help to explain the relatively low numbers of observed CRS cases per year despite potentially large burdens of disease. Our comprehensive review of the weight of the evidence of all pregnancy outcomes demonstrates the importance of including all outcomes in models that characterize Rubella-related disease burdens and costs.
-
immunity to polio measles and Rubella in women of child bearing age and estimated congenital Rubella syndrome incidence cambodia 2012
Epidemiology and Infection, 2015Co-Authors: Bunsoth Mao, Kathleen Wannemuehler, Susan E Reef, K Chheng, Emilia Vynnycky, S Buth, Sann Chan Soeung, W Weldon, Linda Quick, Christopher J GregoryAbstract:Significant gaps in immunity to polio, measles, and Rubella may exist in adults in Cambodia and threaten vaccine-preventable disease (VPD) elimination and control goals, despite high childhood vaccination coverage. We conducted a nationwide serological survey during November-December 2012 of 2154 women aged 15-39 years to assess immunity to polio, measles, and Rubella and to estimate congenital Rubella syndrome (CRS) incidence. Measles and Rubella antibodies were detected by IgG ELISA and polio antibodies by microneutralization testing. Age-structured catalytic models were fitted to Rubella serological data to predict CRS cases. Overall, 29.8% of women lacked immunity to at least one poliovirus (PV); seroprevalence to PV1, PV2 and PV3 was 85.9%, 93.4% and 83.3%, respectively. Rubella and measles antibody seroprevalence was 73.3% and 95.9%, respectively. In the 15-19 years age group, 48.2% [95% confidence interval (CI) 42.4-54.1] were susceptible to either PV1 or PV3, and 40.3% (95% CI 33.0-47.5) to Rubella virus. Based on Rubella antibody seroprevalence, we estimate that >600 infants are born with CRS in Cambodia annually. Significant numbers of Cambodian women are still susceptible to polio and Rubella, especially those aged 15-19 years, emphasizing the need to include adults in VPD surveillance and a potential role for vaccination strategies targeted at adults.
-
elimination of endemic measles Rubella and congenital Rubella syndrome from the western hemisphere the us experience
JAMA Pediatrics, 2014Co-Authors: Mark J Papania, Joseph P Icenogle, Susan E Reef, Susan B Redd, Emily Abernathy, Gregory S Wallace, Paul A Rota, Amy Parker Fiebelkorn, Gregory L Armstrong, Albert E BarskeyAbstract:Importance To verify the elimination of endemic measles, Rubella, and congenital Rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic Rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, Rubella, and CRS had been sustained. Objective To review the evidence for sustained elimination of endemic measles, Rubella, and CRS from the United States through 2011. Design, Setting, and Participants Review of data for measles from 2001 to 2011 and for Rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. Main Outcomes and Measures Annual numbers of measles, Rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and Rubella; and measles-mumps-Rubella vaccination coverage levels. Results Since 2001, US reported measles incidence has remained below 1 case per 1 000 000 population. Since 2004, Rubella incidence has been below 1 case per 10 000 000 population, and CRS incidence has been below 1 case per 5 000 000 births. Eighty-eight percent of measles cases and 54% of Rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or Rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and Rubella. Conclusions and Relevance The external expert panel concluded that the elimination of endemic measles, Rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or Rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
Emily Abernathy - One of the best experts on this subject based on the ideXlab platform.
-
seroprevalence of Rubella virus antibodies among pregnant women in the center and south west regions of cameroon
PLOS ONE, 2019Co-Authors: Nadesh Ashukem Taku, Joseph P Icenogle, Valantine Ngum Ndze, Emily Abernathy, Lijuan Hao, Diane Wakukouomou, Samuel Wanji, Janefrancis K T AkoachereAbstract:Rubella infection in early pregnancy can lead to miscarriages, fetal death, or birth of an infant with congenital Rubella syndrome (CRS). In Cameroon, like in many developing countries, Rubella surveillance is not well-established. The aim of this study was to determine the prevalence of Rubella virus specific antibodies among pregnant Cameroonians. We conducted a cross-sectional study for Rubella infection among pregnant women attending antenatal clinics in the Center and South-West regions of Cameroon. Demographic data and blood were collected and tested for Rubella specific antibodies (IgG and IgM), and for the IgM positive cases, IgG avidity and real time PCR was done. From December 2015 to July 2017, 522 serum samples were collected and tested from pregnant women. The seroprevalence of Rubella specific IgG was 94.4%, presumably due to immunity induced by wild-type Rubella virus. The seroprevalence of Rubella specific IgM was 5.0%, possibly indicating Rubella infection. However, IgG avidity testing of the IgM positive cases detected high avidity IgGs, ranging from 52.37% to 87.70%, indicating past Rubella infection. 5.6% (29/522) of the participants had negative results for IgG to Rubella virus, indicating susceptibility to Rubella infection. None of the participants had received a Rubella containing vaccine (RCV), but 51% (266/522) of the pregnant women lived in a house with a child with records of at least one dose of RCV. Rubella virus RNA was not detected in the urine of any IgM positive case. Findings from this study show that Rubella infection is significant in Cameroon. Some pregnant women are still susceptible to Rubella infection. For a better management of Rubella infection in pregnancy in Cameroon, consideration should be taken to investigate for IgG-avidity test in cases with positive Rubella IgM result to distinguish between recent from past Rubella infection.
-
genotypes of Rubella virus and the epidemiology of Rubella infections in the democratic republic of the congo 2004 2013
Journal of Medical Virology, 2016Co-Authors: Elizabeth Pukuta, Joseph P Icenogle, Emily Abernathy, Diane Wakukouomou, Benoit Kebela Illunga, Ricardo Obama, Vital Mondonge, Benjamin A Dahl, Balcha G Maresha, Jeanjacques MuyembeAbstract:Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital Rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of Rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of Rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for Rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for Rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for Rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of Rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC Rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of Rubella virus circulating in the DRC. These data contribute to a better understanding of Rubella burden and the dynamics of Rubella virus circulation in Africa. Efforts to establish Rubella surveillance in the DRC are needed to support Rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc.
-
genomic characterization of a persistent Rubella virus from a case of fuch uveitis syndrome in a 73 year old man
Journal of Clinical Virology, 2015Co-Authors: Emily Abernathy, Joseph P Icenogle, Min-hsin Chen, Randall R Peairs, Hassan NamdariAbstract:Abstract Background Many cases of Fuchs’ uveitis have been associated with persistent Rubella virus infection. A 73-year-old male patient with typical Fuchs’ Uveitis Syndrome (FUS) first experienced heterochromia of the left eye at the age fourteen, when Rubella was endemic in the US. Objectives The purposes of this report are to describe the patient’s FUS clinical presentations and to characterize the virus detected in the vitreous fluid. Study design The patient underwent a therapeutic pars plana vitrectomy in May 2013. A real-time RT-PCR assay for Rubella virus was performed on the vitreous fluid by Focus Diagnostics. Additional real-time RT-PCR assays for Rubella virus detection and RT-PCR assays for generation of templates for sequencing were performed at the Centers for Disease Control and Prevention (CDC). Results The results from Focus Diagnostics were positive for Rubella virus RNA. Real-time RT-PCR assays at CDC were also positive for Rubella virus. A Rubella virus sequence of 739 nucleotides was determined and phylogenetic analysis showed that the virus was the sole member of a new phylogenetic group when compared to reference virus sequences. Conclusions While FUS remains a clinical diagnosis, findings in this case support the association between Rubella virus and the disease. Phylogenetic analysis provided evidence that this Rubella virus was likely a previously undetected genotype which is no longer circulating. Since the patient had Rubella prior to 1955, this sequence is from the earliest Rubella virus yet characterized.
-
elimination of endemic measles Rubella and congenital Rubella syndrome from the western hemisphere the us experience
JAMA Pediatrics, 2014Co-Authors: Mark J Papania, Joseph P Icenogle, Susan E Reef, Susan B Redd, Emily Abernathy, Gregory S Wallace, Paul A Rota, Amy Parker Fiebelkorn, Gregory L Armstrong, Albert E BarskeyAbstract:Importance To verify the elimination of endemic measles, Rubella, and congenital Rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic Rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, Rubella, and CRS had been sustained. Objective To review the evidence for sustained elimination of endemic measles, Rubella, and CRS from the United States through 2011. Design, Setting, and Participants Review of data for measles from 2001 to 2011 and for Rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. Main Outcomes and Measures Annual numbers of measles, Rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and Rubella; and measles-mumps-Rubella vaccination coverage levels. Results Since 2001, US reported measles incidence has remained below 1 case per 1 000 000 population. Since 2004, Rubella incidence has been below 1 case per 10 000 000 population, and CRS incidence has been below 1 case per 5 000 000 births. Eighty-eight percent of measles cases and 54% of Rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or Rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and Rubella. Conclusions and Relevance The external expert panel concluded that the elimination of endemic measles, Rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or Rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
-
status of global virologic surveillance for Rubella viruses
The Journal of Infectious Diseases, 2011Co-Authors: Emily Abernathy, Li Jin, Judith M Hubschen, Claude P Muller, David Brown, Katsuhiro Komase, Yoshio Mori, Zhen Zhu, Marilda M Siqueira, Sergey V ShulgaAbstract:The suspected measles case definition captures Rubella cases. Therefore, measles surveillance will be improved in the course of the control and eventual elimination of Rubella transmission. One aspect of Rubella control, virologic surveillance, is reviewed here. A systematic nomenclature for Rubella viruses (RVs) based on 13 genotypes has been established and is updated when warranted by increases in information about RVs. From 2005 through 2010, the genotypes of RVs most frequently reported were 1E, 1G, and 2B, and genotypes 1a, 1B, 1C, 1h, 1j, and 2C were less frequently reported. Virologic surveillance can support Rubella control and elimination. Synopses of Rubella virologic surveillance in various countries, regions, and globally are given, including characterization of viruses from imported cases in a country that has eliminated Rubella and studies of endemic viruses circulating in countries without Rubella control objectives. Current challenges are discussed.
Hidetoshi Nomoto - One of the best experts on this subject based on the ideXlab platform.
-
conjunctivitis the key clinical characteristic of adult Rubella in japan during two large outbreaks 2012 2013 and 2018 2019
PLOS ONE, 2020Co-Authors: Hidetoshi Nomoto, Masahiro Ishikane, Takato Nakamoto, Masayuki Ohta, Shinichiro Morioka, Kei Yamamoto, Satoshi Kutsuna, Shunsuke Tezuka, Junwa Kunimatsu, Norio OhmagariAbstract:Background: Rubella virus infection mainly causes illness with mild fever, rash, and lymphadenopathy in children; however, the clinical characteristics of adult Rubella are not well-known. Methods: An observational study was conducted to compare the characteristics between adult Rubella and adult non-Rubella among participants aged ≥18 years, with suspected symptomatic Rubella. Participants were screened for Rubella-specific IgM expression using an enzyme immune assay kit, at a tertiary care hospital in Japan during two outbreaks (January 2012–December 2013 and January 2018–March 2019). Adult Rubella diagnosis followed strong positive or paired Rubella-specific IgM expression or positive Rubella-specific reverse-transcription-polymerase chain reaction. Patients aged
-
conjunctivitis the key clinical characteristic of adult Rubella in japan during two large outbreaks 2012 2013 and 2018 2019
PLOS ONE, 2020Co-Authors: Hidetoshi Nomoto, Masahiro Ishikane, Takato Nakamoto, Masayuki Ohta, Shinichiro Morioka, Kei Yamamoto, Satoshi Kutsuna, Shunsuke Tezuka, Junwa Kunimatsu, Norio OhmagariAbstract:Background Rubella virus infection mainly causes illness with mild fever, rash, and lymphadenopathy in children; however, the clinical characteristics of adult Rubella are not well-known. Methods An observational study was conducted to compare the characteristics between adult Rubella and adult non-Rubella among participants aged ≥18 years, with suspected symptomatic Rubella. Participants were screened for Rubella-specific IgM expression using an enzyme immune assay kit, at a tertiary care hospital in Japan during two outbreaks (January 2012–December 2013 and January 2018–March 2019). Adult Rubella diagnosis followed strong positive or paired Rubella-specific IgM expression or positive Rubella-specific reverse-transcription-polymerase chain reaction. Patients aged <18 years or with clinically suspected Rubella with weak or negative IgM expression were excluded. Results Overall, 82 adult Rubella and 139 adult non-Rubella, with a median age (interquartile range) of 31 (25–41) years and 34 (27–42) years, respectively, were included. Multivariate analysis showed that conjunctivitis (odds ratio 80.6; 95% confidence interval 13.4–486.3; P <0.001) and male sex (odds ratio 7.1; 95% confidence interval 1.8–28.1; P = 0.005) were significantly associated with adult Rubella. Among men born from 1962 to 1979 (high-risk population, n = 68), conjunctivitis also showed a significant association with adult Rubella in the multivariate analysis (odds ratio 24.2; 95% confidence interval 1.1–553.7; P = 0.046) as these patients were not included in the national vaccination program. There was no difference in the clinical characteristics between one-time vaccination (n = 11) and no vaccination (n = 8) patient in the adult Rubella group. Conclusions Conjunctivitis was the key clinical symptom associated with adult Rubella. For the early diagnosis of adult Rubella, clinicians should focus on assessing conjunctivitis in patients.
