Rubella infection: Advances and challenges in the diagnosis and prevention of Congenital Rubella Syndrome

Main Article Content

Amélia Nkutxi Vueba
Maria do Céu Sousa

Abstract

Rubella remains an important pathogen worldwide, with many cases of congenital rubella syndrome per year. Rubella vaccination is included in the vaccination program of many countries. WHO has set goals for the elimination of measles and rubella and prevention of congenital rubella syndrome by 2020. Worldwide, the rubella vaccine is highly effective and safe, and as a result, endemic rubella transmission has been halted in the Americas since 2009. Incomplete rubella vaccination programs result in continuous disease transmission, as evidenced by major recent outbreaks in some countries around the world. In this review, we present the rubella control, elimination and eradication policies and a brief review of the rubella laboratory diagnosis.

Article Details

Nkutxi Vueba, A., & Céu Sousa, M. do. (2020). Rubella infection: Advances and challenges in the diagnosis and prevention of Congenital Rubella Syndrome. International Journal of Clinical Virology, 4(1), 006–013. https://doi.org/10.29328/journal.ijcv.1001007
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Copyright (c) 2020 Vueba AN, et al.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA. Rubella. Lancet. 2015; 385: 2297-2307. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25576992

Bukasa A, Campbell H, Brown K, Bedford H, Ramsay M, et al. Rubella infection in pregnancy and congenital rubella in United Kingdom, 2003 to 2016. Euro Surveill. 2018; 23: 17-00381. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29766840

Yeshwondm M, Balkachew N, Delayehu B, Mekonen G. Seroepidemiology Study of Cytomegalovirus and Rubella among Pregnant Women at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Ethiop J Health Sci. 2016; 26: 427-438. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28446848

Karacan M, Batukan M, Cebi Z, Berberoglugil M, Levent S, et al. Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet. 2014; 290: 1115-1120. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25027818

Winter AK, Pramanik S, Lessler J, Ferrari M, Grenfell BT, et al. Rubella vaccination in India: identifying broad consequences of vaccine introduction and key knowledge gaps. Epidemiology and Infectious. 2018; 146: 65-77.

Rasti S, Ghasemi FS, Abdoli A, Piroozmand A, Mousavi SG, et al. ToRCH "co-infections" are associated with increased risk of abortion in pregnant women. Congenital Anomalies (Kyoto). 2016; 56: 73-78. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26499091

Martínez-Quintana E, Castillo-Solórzano C, Torner N, Rodríguez-González F. Congenital rubella syndrome: a matter of concern. Rev Panam Salud Publica. 2015; 37: 179-186. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25988255

Tamirat B, Hussen S, Shimelis T. Rubella virus infection and associated factors among pregnant women attending the antenatal care clinics of public hospitals in Hawassa City, Southern Ethiopia: a cross-sectional study. BMJ Open. 2017; 7: e016824. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28982820

Vynnycky E, Yoshida LM, Huyen DT, Trung ND, Toda K, et al. Modeling the impact of rubella vaccination in Vietnam. Human Vaccines & Immunotherapeutics. 2016; 12: 150-158. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26260857

Plotkin S. History of vaccination. Proc Natl Acad Sci U S A. 2014; 111: 12283-12287. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25136134

Su Q, Ma C, Wen N, Fan C, Yang H, et al. Epidemiological profile and progress toward rubella elimination in China. 10 years after nationwide introduction of rubella vaccine. Vaccine. 2018; 36: 2079-2085. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29550193

Zanga J, Mbanzulu MK, Kabasele AF, Ngatu NR, Wumba DR. Rubella Seroprevalence and real-time PCR detection of RUBV among Congolese pregnant women. BMC Infect Dis. 2017; 17: 250. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28381214

Orenstein WA, Hinman A, Nkowane B, Olivé JM, Reingold AL. Measles and Rubella Global Strategic Plan 2012-2020 midterm review. Vaccine. 2018; 36 Suppl 1: A1-A34. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29307367

Grant GB, Desai S, Dumolard L, Kretsinger K, Reef SE. Progress toward Rubella and Congenital Rubella Syndrome Control and Elimination - Worldwide, 2000-2018. MMWR Morbidity and Mortality Weekly Report. 2019; 68: 855-859.

Wu Y, Wood J, Khandaker G, Waddington C, Snelling T. Informing rubella vaccination strategies in East Java, Indonesia through transmission modelling. Vaccine. 2016; 34: 5636-5642. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27670077

Hui SYA, Sahota DS, Lao TT. Impact of the two-dose rubella vaccination regimen on incidence of rubella seronegativity in gravidae aged 25 years and younger. PLoS One. 2017; 12: e0183630. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28854204

Plans P, de Ory F, Campins M, Álvarez E, Payà T, et al. Prevalence of anti-rubella, anti-measles and anti-mumps IgG antibodies in neonates and pregnant women in Catalonia (Spain) in 2013: susceptibility to measles increased from 2003 to 2013. Eur J Clin Microbiol Infect Dis. 2015; 34: 1161-1171. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25666082

O'Connor C, Le Blanc D, Drew RJ. Epidemiological changes in rubella IgG antibody levels detected in antenatal women from a retrospective rubella seroprevalence study. Ir J Med Sci. 2018; 187: 689-692. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29209940

Skidmore S, Boxall E, Lord S. Is the MMR vaccination programme failing to protect women against rubella infection? Epidemiology and Infection. 2014; 142: 1114-1117. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23953764

Andrus JK, Cochi SL, Cooper LZ, Klein JD. Combining Global Elimination of Measles and Rubella with Strengthening Of Health Systems in Developing Countries. Health Affairs (Millwood). 2016; 35: 327-33. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26858388

Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, et al. Rubella and pregnancy: diagnosis, management and outcomes. Prenatal Diagnosis. 2014; 34: 1246-53. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25066688

Seppälä EM, López-Perea N, Torres de Mier MV, Echevarría JE, Fernández-García A, et al. Last cases of rubella and congenital rubella syndrome in Spain, 1997-2016: The success of a vaccination program. Vaccine. 2019; 37: 169-175. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30454948

Pukuta E, Waku-Kouomou D, Abernathy E, Illunga BK, Obama R, et al. Genotypes of rubella virus and the epidemiology of rubella infections in the Democratic Republic of the Congo, 2004-2013. J Med Virol. 2016; 88: 1677-1684. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27479298

Cheng WY, Wang HC, Liu MT, Wu HS. Molecular surveillance of rubella viruses in Taiwan from 2005 to 2011. Journal of Medical Virology. 2013; 85: 745-753. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23417619

World Health Organization (WHO). Measles and Rubella Surveillance Data 10 January 2020 17:54 CET.

Yamamoto AY, Castellucci RA, Aragon DC, Mussi-Pinhata MM. Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection. Epidemiol Infect. 2013; 141: 2187-2191. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23200458

Thompson KM, Badizadegan ND. Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases. Risk Analysis. 2017; 37: 1109-1131. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28561947

Getahun M, Beyene B, Gallagher K, Ademe A, Teshome B, et al. Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009-2015. BMC Public Health. 2016; 16: 1168. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27863513

Grangeot-Keros L, Bouthry E, Vauloup-Fellous C. Rubella: a current issue? Presse Medicale. 2014; 43: 698-705. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24785141

George S, Viswanathan R, Sapkal GN. Molecular aspects of the teratogenesis of rubella virus. Biol Res. 2019; 52: 47. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31455418

Boucoiran I, Castillo E. No. 368-Rubella in Pregnancy. J Obstet Gynaecol Can. 2018; 40: 1646-1656. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30527073

Grant GB, Reef SE, Dabbagh A, Gacic-Dobo M, Strebel PM. Global Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination - 2000-2014. MMWR Morbidity and Mortality Weekly Report. 2015; 64: 1052-1055. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26401958

Kaushik A, Verma S, Kumar P. Congenital rubella syndrome: A brief review of public health perspectives. Indian J Public Health. 2018; 62: 52-54. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29512566

Epidemiology and prevention of Vaccine- Preventable Diseases. Rubella 2019. Ref: https://www.cdc.gov/vaccines/pubs/pinkbook/rubella.html#congenital

Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, et al. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clin Microbiol Infect. 2017; 23: 511-515. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28412379

Namuwulya P, Abernathy E, Bukenya H, Bwogi J, Tushabe P, et al. Phylogenetic analysis of rubella viruses identified in Uganda, 2003-2012. J Med Virol. 2014; 86: 2107-2113. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24700073

Zheng Q, Abernathy ES, Sun H, Zhu Z, de Filippis A, et al. Genotyping of rubella virus RNA in sera and dried blood spots collected during routine surveillance and in archival sera. J Virol Methods. 2013; 187: 284-287. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23201287

Rota PA1, Brown KE, Hübschen JM, Muller CP, Icenogle J, et al. Improving global virologic surveillance for measles and rubella. J Infect Dis. 2011; 204: S506-S513. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21666207

Hubschen JM, Kremer JR, De Landtsheer S, Muller CP. A multiplex TaqMan PCR assay for the detection of measles and rubella virus. J Virol Methods. 2008; 149: 246-250. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18353451

Takao S, Shigemoto N, Shimazu Y, Tanizawa Y, Fukuda S, et al. Detection of exanthematic viruses using a TaqMan real-time PCR assay panel in patients with clinically diagnosed or suspected measles. Jpn J Infect Dis. 2012; 65: 444-448. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22996223

Macé M, Cointe D, Six C, Levy-Bruhl D, Parent du Châtelet I, et al. Diagnostic value of reverse transcription-PCR of amniotic fluid for prenatal diagnosis of congenital rubella infection in pregnant women with confirmed primary rubella infection. J Clin Microbiol. 2004; 42: 4818-4820. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15472350

Bosma TJ, Corbett KM, Eckstein MB, O’shea S, Vijayalakshmi P, et al. Use of PCR for prenatal and postnatal diagnosis of congenital rubella. J Clin Microbiol. 1995; 33: 2881-2887. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8576339

Daffos F, Forestier F, Grangeot-Keros L, Capella Pavlovsky M, Lebon P, Chartier M, Pillot J. Prenatal diagnosis of congenital rubella. Lancet. 1984; 2: 1-3. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6145931

Morgan-Capner P, Rodeck CH, Nicolaides KH, Cradock-Watson JE. Prenatal detection of rubella-specific IgM in fetal sera. Prenatal Diagnosis. 1985; 5: 21-26. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3975220

Curti SP, Figueiredo CA, de Oliveira MI, Andrade JQ, Zugaib M, et al. Prenatal diagnosis of congenital rubella infection in São Paulo. Revista da Associação Medica Brasileira 2014; 60: 451-456.

Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, et al. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clinical Microbiology and Infection. 2017; 23: 511-515. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28412379

Mosquera Mdel M, de Ory F, Moreno M, Echevarria, JE. Simultaneous detection of measles virus, rubella virus, and parvovirus B19 by using multiplex. J Clin Microbiol. 2002; 40: 111-116. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11773102

Vueba NA, Sousa MC. Seroprevalence of Rubella Virus in Pregnant Women Attending at Maternity Lucrécia Paim, Luanda, Angola. The 2018 PharmSci 360, T1230-04-027. Ref: https://www.eventscribe.net/2018/PharmSci360/fsPopup.asp?efp=UUFSQlZZVFM1OTQ2&PosterID=165821&rnd=0.8183299&mode=posterinfo

UNICEF. Tire as suas dúvidas sobre vacinas. 2018. Ref: https://www.unicef.org/angola/duvidas-sobre-vacinas

Ministério da Saúde. (MINSA). Vacina da rubéola na rede de saúde. Jornal de Angola. 28 de Abril, 2017. Ref: http://jornaldeangola.sapo.ao/sociedade/saude_e_educacao/vacina_da_rubeola_na_rede_de_saude