Seroepidemiological study of rubella in Vojvodina, Serbia: 24 years after the introduction of the MMR vaccine in the national immunization programme


Autoři: Aleksandra Patić aff001;  Mirjana Štrbac aff003;  Vladimir Petrović aff001;  Vesna Milošević aff001;  Mioljub Ristić aff001;  Ivana Hrnjaković Cvjetković aff001;  Snežana Medić aff001
Působiště autorů: Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia aff001;  Centre for Virology, Institute of Public Health of Vojvodina, Novi Sad, Serbia aff002;  Centre for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227413

Souhrn

Although rubella is usually a mild childhood disease, this infection in early pregnancy poses a serious problem due to its teratogenic effect. The goal of interrupted circulation and elimination of rubella virus was achieved in many countries in the world. The aim of this study was to determine the status of rubella immunity in Vojvodina and evaluate Serbia’s progress toward this goal. A total of 3404 residual serum samples from patients of all ages (1 to 84 years) were included in the study. Samples were collected between May 2015 and December 2017 in Vojvodina. Rubella IgG antibodies were determined using an indirect chemiluminescent immunoassay. Percentage of participants seropositive for rubella antibodies was 92.9% in the entire sample. The highest number of seronegatives was in the youngest (1 year) age group (44.7%), followed by the group aged 24–49 (6.4%) and 2–11 years (6.2%). The absence of a higher percentage of children with protective anti-rubella antibodies in the group aged 2–11 can be explained by a lower immunization coverage during certain years. Participants in the group aged 24–49 were born during the pre-vaccination period with lower rubella incidence, leading to the conclusion that not all individuals of that age came into a contact with the virus. Comparing levels of anti-rubella IgG antibodies of seropositive males and females of different ages reveals that the immunity after a contact with the virus and a previously acquired infection is stronger than the immunity after the vaccination. Although the incidence rate of rubella in Vojvodina has been low for the last ten years, there is still a risk of an outbreak due to a decrease in immunization coverage. This study shows that the percentage of susceptible individuals is high, especially considering women aged 24–49, and that additional ("catch-up") immunization is required.

Klíčová slova:

Age groups – Antibodies – Immunity – MMR vaccine – Rubella – Rubella virus – Serbia – Vaccination and immunization


Zdroje

1. Cooper LZ. The history and medical consequences of rubella. Rev Infect Dis 1985; 7(Suppl 1):2–10. doi: 10.1093/clinids/7.Supplement_1.S2 3890105

2. Miller E, Cradock-Watson JE, Pollock TM. Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet. 1982;2(8302):781–4. doi: 10.1016/s0140-6736(82)92677-0 6126663

3. Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA. Rubella. Lancet. 2015; 385(9984):2297–307. doi: 10.1016/S0140-6736(14)60539-0 25576992

4. Grant GB, Reef SE, Patel M, Knapp JK, Dabbagh A. Progress in Rubella and Congenital Rubella Syndrome Control and Elimination—Worldwide, 2000–2016. MMWR Morb Mortal Wkly Rep. 2017; 66(45):1256–60. doi: 10.15585/mmwr.mm6645a4 29145358

5. World Health Organization. Eliminating measles and rubella—Framework for the verification process in the WHO European Region [Internet]. Copenhagen: WHO; 2014 [accessed 2019 March 9]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0009/247356/Eliminating-measles-and-rubella-Framework-for-the-verification-process-in-the-WHO-European-Region.pdf?ua=1

6. Institute of Public Health of Vojvodina. [Communicable diseases in Vojvodina, 2017. Annual report]. Novi Sad: Institute of Public Health of Vojvodina; 2018. Serbian.

7. Šeguljev Z. Rubeola. U: Petrović V, urednik. Imunizacija protiv zaraznih bolesti. Novi Sad: Medicinski fakultet; 2015. p. 115–120. Serbian.

8. Institute of Public Health of Serbia. Guideline for epidemiological surveillance of Measles, Rubella and Congenital Rubella Syndrome. Belgrade. 2008. Serbian.

9. Official Gazette of the Republic of Serbia No. 88/02017. Regulation on Immunization and Manner of Protection by Medications. [accessed 2019 January 15]. Available from: http://www.paragraf.rs/propisi/pravilnik_o_imunizaciji_i_nacinu_zastite_lekovima.html. Serbian.

10. Statistical Office of the Republic of Serbia. 2011 Census of Population, Households and Dwellings in the Republic of Serbia. [accessed 2019 January 15]. Available from: http://pod2.stat.gov.rs/ObjavljenePublikacije/Popis2011/Nacionalna%20pripadnost-Ethnicity.pdf. Serbian/English.

11. World Health Organization. Immunization coverage. Department for Vaccines and Biologicals, Immunization, Surveillance and Monitoring System. [accessed 2019 March 9]. Available from: https://www.who.int/immunization/monitoring_surveillance/routine/coverage/en/

12. Medić S, Katsilieris M, Lozanov-Crvenković Z, Siettos CI, Petrović V, Milošević V, et al. Varicella zoster virus transmission dynamics in Vojvodina, Serbia. PLoS One. 2018;13(3):e0193838. doi: 10.1371/journal.pone.0193838 29505590

13. Siemens Healthcare Diagnostics. Assay for the Detection of IgG Antibodies to Rubella Virus. Tarrytown, NY: Siemens Healthcare Diagnostics. 2012.

14. European Centre for Disease Prevention and Control. Monthly measles and rubella monitoring report, September 2018. Stockholm: ECDC; 2018.

15. Mossong J, Putz L, Schneider F. Seroprevalence of measles, mumps and rubella antibodies in Luxembourg: results from a national cross-sectional study. Epidemiol Infect. 2004;132(1):11–8. doi: 10.1017/s0950268803001584 14979584

16. Nardone A, Tischer A, Andrews N, Backhouse J, Theeten H, Gatcheva N, et al. Comparison of rubella seroepidemiology in 17 countries: progress towards international disease control targets. Bull World Health Organ. 2008;86(2):118–25. doi: 10.2471/BLT.07.042010 18297166

17. WHO Europe. Measles and rubella elimination country profiles. [accessed 2019 January 15]; Available from: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/surveillance-and-data/measles-and-rubella-elimination-country-profiles

18. Đurišić S, Vuković B, Stefanović S, Šeguljev Z, Milošević V. Rubela u Vojvodini (Deo V) Distribucija i vrednost titra HI-antitela za rubela-virus u osoba različitih dobnih grupa. Med. Pregl. 1988;41(7–8):292–5. Serbian. 3246978

19. WHO. Strategic plan for measles and congenital rubella infection in the European Region of WHO. Copenhagen: WHO Regional Office for Europe; 2003.

20. Waaijenborg S, Hahné SJ, Mollema L, Smits GP, Berbers GA, van der Klis FR, et al. Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage. J Infect Dis. 2013 Jul;208(1):10–6. doi: 10.1093/infdis/jit143 23661802

21. Nicoara C, Zäch K, Trachsel D, Germann D, Matter L. Decay of passively acquired maternal antibodies against measles, mumps, and rubella viruses. Clin Diagn Lab Immunol. 1999;6(6):868–71. 10548578

22. Kurugöl Z, Midyat L, Türkoğlu E, Ozacar T. Rubella seroprevalence among healthy individuals in Izmir, Turkey. Hum Vaccin. 2011;7(9):972–5. doi: 10.4161/hv.7.9.16370 21860258

23. Poethko-Müller C, Mankertz A. Seroprevalence of measles-, mumps- and rubella-specific IgG antibodies in German children and adolescents and predictors for seronegativity. PLoS One. 2012;7(8):e42867 doi: 10.1371/journal.pone.0042867 22880124

24. Ristić M, Milošević V, Medić S, Djekić Malbaša J, Rajčević S, Boban J, et al. Sero-epidemiological study in prediction of the risk groups for measles outbreaks in Vojvodina, Serbia. PLoS One. 2019;14(5):e0216219. doi: 10.1371/journal.pone.0216219 31071124.

25. Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. Report on the Immunization in the Republic of Serbia in 2017. [Accessed 2019 October 15]. Available from: http://www.batut.org.rs/download/izvestaji/Godisnji%20izvestaj%20imunizacija%202017.pdf Serbian.

26. Gioula G, Diza-Mataftsi E, Alexiou-Daniel S, Kyriazopoulou-Dalaina V. Seroepidemiology of rubella in northern Greece. Eur J Clin Microbiol Infect Dis. 2004;23(8):631–3. doi: 10.1007/s10096-004-1172-y 15243817

27. Gallone MS, Gallone MF, Larocca AMV, Germinario C, Tafuri S. Lack of immunity against rubella among Italian young adults. BMC Infect Dis. 2017;17(1):199. doi: 10.1186/s12879-017-2295-y 28270106

28. Smits G, Mollema L, Hahné S, de Melker H, Tcherniaeva I, van der Klis F, et al. Seroprevalence of rubella antibodies in The Netherlands after 32 years of high vaccination coverage. Vaccine. 2014;32(16):1890–5. doi: 10.1016/j.vaccine.2014.01.066 24513012

29. Plans P, de Ory F, Campins M, Álvarez E, Payà T, Guisasola E, 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(6):1161–71. doi: 10.1007/s10096-015-2339-4 25666082

30. Pebody RG, Gay NJ, Hesketh LM, Vyse A, Morgan-Capner P, Brown DW, et al. Immunogenicity of second dose measles-mumps-rubella (MMR) vaccine and implications for serosurveillance. Vaccine. 2002;20(7–8):1134–40. doi: 10.1016/s0264-410x(01)00435-2 11803074

31. Herrera OR, Thornton TA, Helms RA, Foster SL. MMR Vaccine: When Is the Right Time for the Second Dose?. J Pediatr Pharmacol Ther. 2015;20(2):144–148. doi: 10.5863/1551-6776-20.2.144 25964732


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