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Friedrich N, Poethko-Müller C, Kuhnert R, Matysiak-Klose D, Koch J, Wichmann O, Santibanez S, Mankertz A. Seroprevalence of Measles-, Mumps-, and Rubella-specific antibodies in the German adult population - cross-sectional analysis of the German Health Interview and Examination Survey for Adults (DEGS1). THE LANCET REGIONAL HEALTH. EUROPE 2021; 7:100128. [PMID: 34557838 PMCID: PMC8454806 DOI: 10.1016/j.lanepe.2021.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The WHO European Region targets the elimination of measles, rubella, and the congenital rubella syndrome and welcomes mumps elimination via the joint MMR vaccine. In a push towards this elimination goal, Germany introduced a recommendation on MMR vaccination for adults in 2010 to prevent increasing numbers of measles cases among adults and to strengthen herd immunity. METHODS The prevalence of anti-measles, -mumps, and -rubella IgG antibodies was analysed in 7,115 participants between the ages of 18 and 79 years in the German Health Interview and Examination Survey. Risk factors of seronegativity of adults born 1970 or later were determined. FINDINGS The seroprevalence of anti-measles IgG antibodies was more than 97% in adults born before 1965 and less than 90% in adults born afterwards. Prevalence and GMTs declined with later years of birth. Seronegativity was associated with two-sided migration background and region of residence in East Germany. For anti-mumps IgG antibodies, the seroprevalence was less than 90% in almost all age groups. Prevalence and GMTs declined with later years of birth. Seronegativity was not associated with any socio-demographic factor. Anti-rubella IgG seropositivity was found in more than 90% of adults born before 1985. GMTs declined in younger age groups. Seronegativity was associated with birth between 1980 and 1993 and male gender. High socio-economic status lowered the odds of being seronegative. INTERPRETATION These data reinforce the implementation of the vaccination recommendation for adults and provide the basis for further evaluation of this measure. FUNDING The Federal Ministry of Health, Germany.
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Affiliation(s)
- Nicole Friedrich
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | | | - Ronny Kuhnert
- Epidemiological Data Centre, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany
| | | | - Judith Koch
- Immunization Unit, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Sabine Santibanez
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Annette Mankertz
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
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Riera-Montes M, Bollaerts K, Heininger U, Hens N, Gabutti G, Gil A, Nozad B, Mirinaviciute G, Flem E, Souverain A, Verstraeten T, Hartwig S. Estimation of the burden of varicella in Europe before the introduction of universal childhood immunization. BMC Infect Dis 2017; 17:353. [PMID: 28521810 PMCID: PMC5437534 DOI: 10.1186/s12879-017-2445-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/07/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination. METHODS We conducted a systematic literature review to identify all available epidemiological data on varicella IgG antibody seroprevalence, primary care and hospitalisation incidence, and mortality. We then developed methods to estimate age-specific varicella incidence and annual number of cases by different levels of severity (cases in the community, health care seekers in primary care and hospitals, and deaths) for all countries belonging to the European Medicines Agency (EMA) region and Switzerland. RESULTS In the absence of universal varicella immunization, the burden of varicella would be substantial with a total of 5.5 million (95% CI: 4.7-6.4) varicella cases occurring annually across Europe. Variation exists between countries but overall the majority of cases (3 million; 95% CI: 2.7-3.3) would occur in children <5 years. Annually, 3-3.9 million patients would consult a primary care physician, 18,200-23,500 patients would be hospitalised, and 80 varicella-related deaths would occur (95% CI: 19-822). CONCLUSIONS Varicella disease burden is substantial. Most cases occur in children <5 years old but adults require hospitalisation more often and are at higher risk of death. This information should be considered when planning and evaluating varicella control strategies. A better understanding of the driving factors of country-specific differences in varicella transmission and health care utilization is needed. Improving and standardizing varicella surveillance in Europe, as initiated by the European Centre for Disease Prevention and Control (ECDC), is important to improve data quality to facilitate inter-country comparison.
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Affiliation(s)
- Margarita Riera-Montes
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium.
| | - Kaatje Bollaerts
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Ulrich Heininger
- Division of Paediatric Infectious Diseases and Vaccinology, University of Basel Children's Hospital, CH-4056, Basel, Switzerland
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Antwerp, Belgium.,Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Angel Gil
- Universidad Rey Juan Carlos, Madrid, Spain
| | - Bayad Nozad
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Grazina Mirinaviciute
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - Elmira Flem
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Thomas Verstraeten
- P95 Pharmacovigilance and Epidemiology Services, Koning Leopold III Laan 1, 3001, Leuven, Belgium
| | - Susanne Hartwig
- Sanofi Pasteur MSD, 162 avenue Jean Jaurès, 69007, Lyon, France
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De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World J Virol 2016; 5:97-124. [PMID: 27563537 PMCID: PMC4981827 DOI: 10.5501/wjv.v5.i3.97] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/08/2016] [Accepted: 07/22/2016] [Indexed: 02/05/2023] Open
Abstract
Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.
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Plans P, de Ory F, Campins M, Álvarez E, Payà T, Guisasola E, Compte C, Vellbé K, Sánchez C, Lozano MJ, Aran I, Bonmatí A, Carreras R, Jané M, Cabero L. 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; 34:1161-71. [PMID: 25666082 DOI: 10.1007/s10096-015-2339-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 01/26/2015] [Indexed: 11/25/2022]
Abstract
Non-immune neonates and non-immune pregnant women are at risk of developing rubella, measles and mumps infections, including congenital rubella syndrome. We describe the seroepidemiology of measles, mumps and rubella (MMR) in neonates and pregnant women in Catalonia (Spain). Anti-rubella, anti-measles and anti-mumps serum IgG titres were assessed using enzyme-linked immunosorbent assay (ELISA) tests in 353 cord blood samples from neonates of a representative sample of pregnant women obtained in 2013. The prevalence of protective antibody titres in neonates was 96 % for rubella IgG (≥8 IU/ml), 90 % for measles IgG (>300 IU/ml) and 84 % for mumps IgG (>460 EU/ml). Slightly lower prevalences of protective IgG titres, as estimated from the cord blood titres, were found in pregnant women: 95 % for rubella IgG, 89 % for measles IgG and 81 % for mumps IgG. The anti-measles and anti-mumps IgG titres and the prevalences of protective IgG titres against measles and mumps increased significantly (p < 0.001) with maternal age. The prevalence of protective anti-measles IgG titres decreased by 7 % [odds ratio (OR) = 0.15, p < 0.001), the prevalence of protective anti-rubella IgG titres increased by 3 % (OR = 1.80, p < 0.05) and the MMR vaccination coverage (during childhood) in pregnant women increased by 54 % (OR = 2.09, p < 0.001) from 2003 to 2013. We recommend to develop an MMR prevention programme in women of childbearing age based on mass MMR vaccination or MMR screening and vaccination of susceptible women to increase immunity levels against MMR.
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Affiliation(s)
- P Plans
- Public Health Agency of Catalonia, Department of Health of Catalonia, Roc Boronat 83-95, 008005, Barcelona, Spain,
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Tafuri S, Gallone MS, Cappelli MG, Gallone MF, Larocca AMV, Germinario C. A seroprevalence survey on varicella among adults in the vaccination era in Apulia (Italy). Vaccine 2014; 32:6544-7. [PMID: 25236583 DOI: 10.1016/j.vaccine.2014.08.088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 08/20/2014] [Accepted: 08/21/2014] [Indexed: 01/11/2023]
Abstract
In 2006, the Apulia Region (Italy) introduced universal routine vaccination (URV) against varicella disease. The coverage for one dose of varicella vaccine at 24 month of age reached 91.1% in 2010 birth-cohort. Vaccination coverage for the second dose at 5-6 years was 64.8% for the cohort 2005, and 28.8% for adolescents born in 1997. The aim of the present study is to evaluate the pattern of immunity/susceptibility to varicella in Apulian adults by a seroprevalence survey carried out 6 years after the introduction of URV. The study was carried out from May 2011 to June 2012 among blood donors of the Department of Transfusion Medicine of Policlinico General Hospital in Bari. Subjects were enrolled by a convenience sample. For each enrolled patient we collected a sample of serum of 5 ml. Anti-VZV IgG in collected sera were analyzed by chemiluminescence (CLIA). We enrolled 1769 subject; 1365 (77.2%) were male with a mean age of 38.4 ± 11.7 years. 93% (95% CI=91.7-94.1) of enrolled subject presented a titre of anti-VZV IgG >164 mIU/mL. GMT of anti-VZV IgG titre was 1063.4 mIU/ml and no difference was observed between different age group. According to our data, URV did not seem to have any impact on susceptibility among adults and in particular we did not note any cluster of susceptible subjects among young adults. Also in the vaccination era, we did not note that the average age of infection shifts among adults and then we could exclude an increase of case of complicated varicella related to the URV.
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Affiliation(s)
- S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
| | - M S Gallone
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - M G Cappelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - M F Gallone
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - A M V Larocca
- Hygiene Department, Policlinico General Hospital, Bari, Italy
| | - C Germinario
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
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Seroprevalence of anti-rubella and anti-measles IgG antibodies in pregnant women in Shiraz, Southern Iran: outcomes of a nationwide measles-rubella mass vaccination campaign. PLoS One 2013; 8:e55043. [PMID: 23383049 PMCID: PMC3561451 DOI: 10.1371/journal.pone.0055043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 12/18/2012] [Indexed: 02/05/2023] Open
Abstract
Objective Nonimmune pregnant women are at risk of developing congenital rubella syndrome and measles complications. We aimed to identify pregnant women susceptible to rubella or measles in order to determine the need for immunity screening and supplemental immunization in women of childbearing age. Method This seroprevalence survey was conducted by convenience sampling in obstetric hospitals affiliated with Shiraz University of Medical Sciences (southern Iran). Serum IgG levels were measured by ELISA. Result Mean age of the 175 pregnant women was 27.3±5.3 (range 16 to 42) years. The geometric mean concentration of anti-rubella IgG was 14.9 IU/mL (CI 95%,14.1–15.5), and that of anti-measles IgG was 13.8 IU/mL (CI 95%, 13–14.5). One hundred sixty-eight women (96%) had a protective serologic level (>11 IU/mL) of IgG against rubella, and 143 (81.7%) had a protective level against measles. Except for a significant inverse correlation that was showed by univariate analysis between anti-rubella IgG and the women’s age (P = 0.01), immunity did not correlate with demographic or obstetric characteristics or medical history. There was no significant correlation between anti-rubella and anti-measles IgG levels (P = 0.25). Conclusion Nearly a decade after Iran’s nationwide measles-rubella vaccination campaign for the population aged 5–25 years, most pregnant women up to 34 years of age had humoral immunity against rubella. We recommend rubella immunity screening or catch-up immunization for women older than 35 years who wish to become pregnant, and measles immunity screening and appropriate vaccination for all women of childbearing age.
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Wicker S, Friedrichs I, Rabenau HF. [Seroprevalence of antibodies against infectious pathogens relevant to pregnancy among healthcare workers]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:923-9. [PMID: 22842885 PMCID: PMC7080042 DOI: 10.1007/s00103-012-1509-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Healthcare workers (HCWs) are exposed to infectious diseases throughout the course of their work. The concerns of pregnant HCWs are considerable because certain otherwise mild infections may affect fetal development. We studied 424 pregnant HCWs at the University Hospital Frankfurt between March 2007 and July 2011. Serological tests were carried out for varicella zoster virus (VZV), measles, mumps, rubella (MMR), cytomegalovirus (CMV) and parvovirus B19. Our overall seroprevalence data with regard to VZV, MMR, CMV and parvovirus B 19 corresponded to the general population. However, physicians demonstrated lower seroprevalence towards the two non-vaccine-preventable diseases (CMV: 37.5% [KI 27.4-48.5]; parvovirus B19: 69.3% [KI 58.6-78.7]) compared with nurses (CMV: 53.4% [KI 46.1-60.6], parvovirus B19: 75.1% [68.4-81.1]). It was striking that, only one in five of the study population showed IgG antibodies against all of the six pregnant-relevant viral diseases tested, of the physicians as few as one in six. A routine exclusion from the workplace due to non-immunity would mean that it would not be possible to employ the majority of pregnant staff in healthcare and childcare.
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Affiliation(s)
- S Wicker
- Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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Guido M, Tinelli A, De Donno A, Quattrocchi M, Malvasi A, Campilongo F, Zizza A. Susceptibility to varicella-zoster among pregnant women in the province of Lecce, Italy. J Clin Virol 2011; 53:72-6. [PMID: 22074933 DOI: 10.1016/j.jcv.2011.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/21/2011] [Accepted: 10/14/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND Varicella is predominantly a childhood disease, considered a mild self-limiting disease that can have serious complications for a pregnant woman and her developing fetus. OBJECTIVES We investigated the susceptibility to varicella-zoster Virus (VZV) among pregnant women in the province of Lecce. STUDY DESIGN A cross-sectional study was carried out in Departments of Gynecology and Obstetrics of the Province of Lecce, where 539 pregnant women were recruited, and face-to-face interviews were conducted. Varicella IgG tests were performed. RESULTS The prevalence of varicella susceptibility among pregnant mothers was 10.6%. The prevalence of IgG antibodies increases significantly with increasing age, from 62.5% in the age group 15-19 years to 94.4% in the age group 40-49 years. DISCUSSION In the Italian National Vaccination Plan 2005-2007, varicella vaccine is only recommended for childbearing women. A safe and effective vaccine is available and no abnormalities have been observed among infants born to susceptible women who received varicella vaccines during pregnancy. Such a high number of susceptible women indicates that preventive and informative programs should be introduced, even among those who do not plan to become pregnant. Routine counselling, varicella IgG antibody screening and varicella vaccination should be considered if they have no history of the infection, to reduce the risk of fetal complications and the cost of healthcare associated with the infection.
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Affiliation(s)
- M Guido
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
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Plans P, Costa J, Espuñes J, Plasència A, Salleras L. Prevalence of varicella-zoster antibodies in pregnant women in Catalonia (Spain). Rationale for varicella vaccination of women of childbearing age. BJOG 2007; 114:1122-7. [PMID: 17666097 DOI: 10.1111/j.1471-0528.2007.01454.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this study was to determine the prevalence of antibodies against varicella-zoster virus (VZV) in pregnant women in Catalonia (Spain). SETTING The prevalence of antibodies against VZV was assessed in a representative sample (n = 1522) of pregnant women of Catalonia obtained in 2003. METHOD The sample was obtained including all women attended for childbirth, during 2 months of 2003, in 27 randomly selected hospitals with maternity clinics. MAIN OUTCOME MEASURES Varicella-zoster antibodies were determined using the enzyme-linked immunosorbent assay test. RESULTS The total number of women included in the study was 1522, corresponding to a participation rate of 83%. The prevalence of varicella-zoster antibodies in pregnant women was 96.1% (95% CI 95.1-97.1). The prevalence of antibodies was 94% in pregnant women aged 15-24 years, 95% in those aged 25-29 years and >95% in those aged 30-49 years. The prevalence of antibodies was not associated to the place of birth, place of residence (urban or rural), educational level and social class. The study showed that 6% of pregnant women aged 15-24 years and 5% of those aged 25-29 years were susceptible to varicella-zoster infections in Catalonia (Spain). CONCLUSION The study showed that a varicella-zoster vaccination programme aimed at women of childbearing age could be necessary in Catalonia to prevent all varicella-zoster infections during pregnancy.
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Affiliation(s)
- P Plans
- General Directorate of Public Health, Department of Health, Generalitat of Catalonia, Barcelona, Spain.
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Abstract
World Health Organization has the target by the year 2010 of reducing congenital rubella syndrome to less than 1/100,000 live births, being necessary the control of the virus circulation. Rubella is currently a low-incidence disease, that affected to children in the pre-vaccine era. The excellent measles-mumps-rubella vaccine coverage in children, together with the vaccination campaigns in childbearing age women, leads to get very high protection. Until recently, susceptible individuals were grouped in a reduced fraction of young men, born after the decline of wild virus circulation and that did not receive the vaccine, due to its age. The new demographic situation derived from the immigration is causing important changes in the susceptibility pattern. Many immigrants came to Spain from regions where rubella vaccine is not (or until recently was not) administered; as result, it can emerge an accumulation of susceptible individuals (especially among adults) allowing the re-circulation of the virus.
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Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública, Instituto de Salud Pública de la Comunidad de Madrid, Spain
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Enders M, Rist B, Enders G. Abort- und Frühgeburtenrate nach akuter Mumpsinfektionin der Schwangerschaft. ACTA ACUST UNITED AC 2004; 45:39-43. [PMID: 15644639 DOI: 10.1159/000081715] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Accepted: 09/06/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Since mumps infection is endemic, the occurrence of acute mumps infection during pregnancy is rare. As a result, data on the possible negative consequences of acute mumps infection on pregnancy outcome are limited. PATIENTS AND METHODS The clinical diagnosis of acute mumps infection was serologically confirmed in 79 pregnant women between January 1985 and December 2002. Data on pregnancy outcome were obtained from the gynaecologist or obstetrician. Cord blood from 26 of the 57 live-born infants was investigated for mumps-specific IgM and IgG antibodies by enzyme-linked immunoassay. RESULTS Sixty-two patients were prospectively followed up with respect to pregnancy outcome. Two of the 62 pregnancies were electively terminated. The overall rate of fetal loss was 6.6% (4/60). Only 2 cases of spontaneous abortion occurred during the first trimester. However, all 4 spontaneous abortions occurred in women who had contracted mumps infection during the first trimester. The time interval between mumps infection and fetal loss varied widely. The median gestational age at delivery was 40 weeks. Only 2 of the 57 live-born infants (3.5%) were delivered before completion of the 37th week of pregnancy. Mumps-specific IgM anti-bodies were not detected in any of the 26 cord blood samples tested. CONCLUSION The lack of mumps-specific antibodies in the cord blood samples tested suggests that prenatal mumps infection did not occur. The frequency of premature birth and spontaneous abortion following mumps infection in pregnancy does not appear to be increased over normal levels.
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Affiliation(s)
- M Enders
- Labor Enders und Partner, Institut fur Virologie, Infektiologie und Epidemiologie eV, Stuttgart, Deutschland.
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