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Background: As infection with rubella and varicella-zoster viruses (VZV) can lead to congenital syndrome and its dangerous complications, assessing immunity to these congenital infections can represent the biological risk assessment related to their exposure in high-risk groups. Therefore, we aimed to evaluate the frequency of IgG anti-varicella/rubella antibodies (Abs) in female students at Shiraz University of Medical Sciences (SUMS), Iran. Patients and Methods: In this study, a total of 434 female students were included. Sera were isolated from blood samples and stored at -20°C for later analysis. A questionnaire form was documented and contained demographic data as well as the history of vaccinations. Enrolled students were divided into recipients of either one or two doses of the measles/rubella (MR) vaccine. Serum samples were analyzed for rubella and VZV IgG Abs using commercial IgG immunoassays. Results: The students were 21.6±4.25 years old on average. Out of the 434 enrolled students, 292 (67.3%) and 287 (66.1%) students were positive for anti-varicella and anti-rubella IgG-Abs, respectively. The frequency of anti-rubella IgG Ab was significantly higher in those who received one dose of MR vaccine (P<0.001). In addition, 205 (47.2%) and 59 (13.6%) students were double-positive (anti-varicella/rubella IgG Abs) and double-negative, respectively. Conclusion: Our results indicated that an additional dose of rubella vaccine may be required for those who received two doses of the vaccine. In addition, we recommend the inclusion of the VZV vaccine in Iran's routine vaccination program. Further studies are recommended to verify these results.

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Background: Hypothesizing that soccer-associated public health campaigns influence men more than women, we investigated the characteristics and motivations of participants who received rubella antibody testing at a Japanese professional football league event. Methods: This was a survey-based cross sectional study, comparing the characteristics and motivations between men and women regarding rubella antibody testing. Results: Free and convenient testing was the biggest behavioral influencer, but the information provided by healthcare professionals and athletes also played a strong motivating role. Men reported more influence from celebrity athletes than women. Conclusions: Public health attention raised by celebrity athletes may facilitate rubella awareness among male spectators.

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This study aimed to identify the factors predicting rubella vaccination status based on self-reported data and the presence of sufficient rubella antibody titers in pregnant women in Japan. We used the results of the nationwide questionnaire survey conducted at obstetric facilities in the Pregnant Women Health Initiative Project (PWHI), with 23 participating hospitals recruiting pregnant women from June 2018-November 2019. We extracted age, the number of deliveries, educational level, household income, pre-pregnancy smoking, and knowledge of rubella from questionnaires and medical records. We analyzed the association of rubella vaccination status and antibodies with each of these factors. We found that the number of previous deliveries, educational level, annual household income, smoking before pregnancy, and knowledge of rubella were factors predicting self-reported rubella vaccination status, while age and the number of previous deliveries were identified as factors predicting the presence of sufficient rubella antibody titers (32 folds or higher). Women considering pregnancy should be immunized against rubella to prevent congenital rubella syndrome in the future. Furthermore, social policies are needed to strongly encourage vaccination, especially for all citizens who were not given the opportunity or missed the chance to be vaccinated against rubella.

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INTRODUCTION: This study aimed to examine the immunity level against rubella in pregnant women of different birth cohorts. METHODS: In total, 512 pregnant women who visited a primary clinic between May 2019 and March 2020 were enrolled. Information in terms of the patients' hemagglutination inhibition (HI) titers, birthdate, obstetrical history, and vaccination history were collected. Participants were divided into three generational groups according to the vaccination policy in Japan. Publicly funded vaccination was administered twice as part of a routine program in group A (n = 11), once as part of a routine program and once in a catch-up program in group B (n = 181), and once in group C (n = 320). RESULTS: All groups had some women with negative rubella HI antibody titers (7.6% of all the women, 18.2% of group A, 9.4% of group B, and 6.3% of group C) and those with rubella HI antibody titers of ≤1:16 (45.1% of all women, 90.9% of group A, 56.4% of group B, and 37.2% of group C). Rubella HI antibody titers differed between the groups; group C had higher titers than that in group B. In groups B and C, the proportions of women with rubella HI antibody titers of ≤1:16 were not statistically different between primipara and multipara. CONCLUSIONS: Our study showed that an increase in immunity to rubella, a vaccine-preventable disease, is nevertheless required among childbearing women to prevent rubella and congenital rubella syndrome.

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Widespread rubella epidemics have sometimes occurred in Japan. We compared the prevalence of rubella antibodies in women who had conceived after infertility treatments and in those who had conceived spontaneously. We reviewed the obstetric records of nulliparous Japanese women who had conceived after infertility treatments and whose babies had been born at the Japanese Red Cross Katsushika Maternity Hospital from 2014 to 2018. No significant differences in the rates of women with rubella antibody titers < 8 or < 32 emerged between those who had been treated and those who had not (titer < 8: 4.1 vs. 3.4%, p = 0.58; titer < 32: 17.3 vs. 15.3%, p = 0.45, respectively). It is necessary to thoroughly implement pre-conception care concerning the risk of congenital rubella infection for women undergoing infertility treatments, especially in Japanese obstetric clinics.

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BACKGROUND: Rubella-containing vaccines (RCV) are not yet part of the Democratic Republic of the Congo's (DRC) vaccination program; however RCV introduction is planned before 2020. Because documentation of DRC's historical burden of rubella virus infection and congenital rubella syndrome (CRS) has been minimal, estimates of the burden of rubella virus infection and of CRS would help inform the country's strategy for RCV introduction. METHODS: A rubella antibody seroprevalence assessment was conducted using serum collected during 2008-2009 from 1605 pregnant women aged 15-46years attending 7 antenatal care sites in 3 of DRC's provinces. Estimates of age- and site-specific rubella antibody seroprevalence, population, and fertility rates were used in catalytic models to estimate the incidence of CRS per 100,000 live births and the number of CRS cases born in 2013 in DRC. RESULTS: Overall 84% (95% CI 82, 86) of the women tested were estimated to be rubella antibody seropositive. The association between age and estimated antibody seroprevalence, adjusting for study site, was not significant (p=0.10). Differences in overall estimated seroprevalence by study site were observed indicating variation by geographical area (p⩽0.03 for all). Estimated seroprevalence was similar for women declaring residence in urban (84%) versus rural (83%) settings (p=0.67). In 2013 for DRC nationally, the estimated incidence of CRS was 69/100,000 live births (95% CI 0, 186), corresponding to 2886 infants (95% CI 342, 6395) born with CRS. CONCLUSIONS: In the 3 provinces, rubella virus transmission is endemic, and most viral exposure and seroconversion occurs before age 15years. However, approximately 10-20% of the women were susceptible to rubella virus infection and thus at risk for having an infant with CRS. This analysis can guide plans for introduction of RCV in DRC. Per World Health Organization recommendations, introduction of RCV should be accompanied by a campaign targeting all children 9months to 14years of age as well as vaccination of women of child bearing age through routine services.

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BACKGROUND: Despite widespread use of a universal rubella standard, variability in rubella antibody titre can be observed between assays, particularly at the low end of the linear range. OBJECTIVES: Here, we investigate the impact of a methodology change for rubella IgG from the Abbott AXSYM to the Abbott Architect in a comprehensive prenatal screening program in the Canadian province of Alberta. STUDY DESIGN: 51,815 specimens (21,399 tested by AxSYM and 30,416 tested by Architect) submitted for routine prenatal screening between January 2006 and December 2012 from women who lived in Alberta after the universal childhood immunization programme for rubella was implemented, and whose immunization records were available, were included in the study. RESULTS: Prenatal samples tested by AxSYM for rubella IgG were approximately 30% higher than those reported by Architect. Among individuals who had tests across multiple pregnancies, the change in test platform led to an additional 7% of women who initially tested positive, becoming non-positive (i.e. negative or indeterminate) in their subsequent tests. The tendency of the Architect IgG assay to report lower quantitative values was demonstrated across all birth cohorts and vaccination status, and resulted in an additional 2800 women requiring vaccination between 2010 and 2012 with an estimated cost of $38,500. CONCLUSION: The change in rubella IgG screening assay resulted in a significant increase in the number of women who required post partum vaccination and Public Health follow-up.

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The ability to determine an individual's susceptibility to infection relies heavily on the assay used, and the ability to correlate results of the assay to a clinical interpretation. Current rubella immunity screening methods identify total rubella IgG antibodies circulating in the serum, however both humoral and cell mediated immune responses have been shown to contribute to protection from infection. Therefore, antibody screening assays may under-estimate immunity in some populations. In fact, waning antibody titers over time in a large prenatal population were recently documented in North America, and the trend has been echoed in other countries that have achieved elimination through universal rubella vaccination. Despite decreasing antibody titers, the number of acute rubella cases has not increased in these populations, suggesting that the lower antibody levels may still be protective. Based on the changing epidemiology in universally vaccinated populations, it may be time to reassess the level of antibody that indicates immunity to rubella infection.

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BACKGROUND: In Korea, there was resurgence of rubella among adolescents in 1995-6. The risk of rubella infection is higher in hospital employees than that in others because of higher chances to exposure to rubella viruses. As rubella infection during pregnancy can cause congenital rubella syndrome, special preventive measures should be taken for female employees under reproductive age in the hospital. METHODS: The subjects were 440 employees(male 100, female 340) aged from 18 to 45 years in Soonchunhyang university hospital. Rubella IgG antibody was assayed by microparticle enzyme immunoassay (MEIA). RESULTS: Among 440 subjects, the positive rate for rubella IgG antibody was 91.4% (402/440) that was 95% (95/100) in male and 90% (307/340) in female. The overall titer of the antibody was 105+/- 113IU/mL (mean+/-SD). The titer of rubella antibody was 144+/-135 IU/mL in male and 94+/-103 IU/mL in female with statistical significance (P<0.05). The titer was 152+/-142 IU/mL in doctor and 90+/- 99 IU/mL in female employee with statistical significance (P<0.05). CONCLUSION: Because 8.6% of hospital employees was susceptible to rubella, we recommended that the hospital employee should be checked for rubella antibody and be vaccinated when they are seronegative.

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BACKGROUND: The risk of rubella infection is higher in hospital workers than in others because of high possibility of exposure to rubella viruses. Moreover, rubella infection during pregnancy can cause serious problems, special preventive measures should be taken for female employees in the hospital. METHODS: This study was performed from October to December, 1995 and the subjects were 307 female employees in a university hospital, who were aged 20 to 40 and had many chances cf exposure to rubella patient during working. Rubella virus antibody was detected by the method of ELISA. For the antibody-negative employees, we gave active immunization and retested the antibody titer after six weeks. RESULTS: Among 307 subjects, 289 cases (94.1%) were positive for rubella IgG antibody. There was no significant difference in positive rates of rubella antibody by type of occupation, age, medical department, and duration employed. The seroconversion rate was 93.8% (15/16). CONCLUSIONS: According to these findings, we recommend that the employees in the hospital, especially women aged 20 to 40 should be checked for Rubella Ab (IgG) and be vaccinated when they don't have it.

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BACKGROUND: The risk of rubella infection is higher in hospital workers than in others because of high possibility of exposure to rubella viruses. Moreover, rubella infection during pregnancy can cause serious problems, special preventive measures should be taken for female employees in the hospital. METHODS: This study was performed from October to December, 1995 and the subjects were 307 female employees in a university hospital, who were aged 20 to 40 and had many chances cf exposure to rubella patient during working. Rubella virus antibody was detected by the method of ELISA. For the antibody-negative employees, we gave active immunization and retested the antibody titer after six weeks. RESULTS: Among 307 subjects, 289 cases (94.1%) were positive for rubella IgG antibody. There was no significant difference in positive rates of rubella antibody by type of occupation, age, medical department, and duration employed. The seroconversion rate was 93.8% (15/16). CONCLUSIONS: According to these findings, we recommend that the employees in the hospital, especially women aged 20 to 40 should be checked for Rubella Ab (IgG) and be vaccinated when they don't have it.

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