RESUMO
Although transmission of rubella virus within the United States is rare, the risk for imported cases persists. We describe a rubella case in a newborn, conceived in Saudi Arabia, in Texas during 2017, highlighting the importance of active surveillance and early diagnosis of this disease.
Assuntos
Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/transmissão , Doença Relacionada a Viagens , História do Século XXI , Humanos , Lactente , Masculino , Síndrome da Rubéola Congênita/história , Síndrome da Rubéola Congênita/virologia , Arábia Saudita , Texas/epidemiologiaAssuntos
Síndrome da Rubéola Congênita/história , Rubéola (Sarampo Alemão)/história , Erradicação de Doenças/estatística & dados numéricos , Feminino , História do Século XX , Humanos , Lactente , Recém-Nascido , Pediatria/história , Gravidez , Rubéola (Sarampo Alemão)/complicações , Rubéola (Sarampo Alemão)/prevenção & controle , Síndrome da Rubéola Congênita/epidemiologiaRESUMO
Epidemiological studies of rubella and congenital rubella syndrome (CRS) in Japan have been conducted since the first nationwide rubella epidemic of 1965-1969 and subsequent epidemics of 1975-1977, 1982, 1987-1988, and 1992-1993. Rubella was non-endemic in Japan before the 1975-1977 epidemic, and endemic thereafter. Japan started a selective rubella vaccination program for junior high school girls in 1977, and universal rubella vaccination of children of both sexes in 1989. No nationwide rubella epidemics have occurred since 1994. Only three children with CRS were reported in Japan before 1964; however, many children with CRS were identified in 1965 when a rubella epidemic struck Okinawa, which has many the United States military bases. After the 1965-1969 and 1975-1977 rubella epidemics on the Japanese mainland, small numbers of children with CRS were identified (hospital survey). These findings led to the hypothesis that, compared to U.S. rubella virus strains, Japanese strains of rubella virus are less teratogenic. This hypothesis strongly affected the development of rubella vaccines in Japan. However, retrospective seroepidemiological studies attributed the CRS in many children in Okinawa to the high rate of rubella infection in pregnant women. According to the survey conducted at special schools for the deaf, 83, 232, 77, and 167 children were born with CRS on the Japanese mainland respectively after the 1965-1969, 1975-1977, 1982, and 1987-1988 nationwide rubella epidemics, suggesting that the incidence of CRS in Japan is in fact comparable to that in the U.S. and Europe. Rubella epidemics in children have been effectively prevented since 1994. However, a rubella outbreak among adult males and CRS occurred between 2012 and 2014.
Assuntos
Epidemias , Síndrome da Rubéola Congênita/epidemiologia , Feminino , História do Século XX , Humanos , Programas de Imunização , Incidência , Japão/epidemiologia , Gravidez , Rubéola (Sarampo Alemão)/prevenção & controle , Síndrome da Rubéola Congênita/história , Vacina contra Rubéola/uso terapêutico , Vírus da Rubéola/classificação , Estudos SoroepidemiológicosRESUMO
By identifying rubella infection in early pregnancy as a cause of congenital malformations and disabilities, Gregg alerted the medical profession to the importance of the prenatal environment.
Assuntos
Oftalmologia/história , Síndrome da Rubéola Congênita/história , Austrália , Catarata/congênito , Catarata/história , História do Século XX , Humanos , Recém-Nascido , New South Wales , Síndrome da Rubéola Congênita/embriologiaRESUMO
On the 65th anniversary of Gregg's observation "Congenital cataract following German measles in the mother", rubella has retired as the leading cause of congenital cataract, from 87% of Gregg's cohort to less than 3% over the last 25 years and almost zero now in Australia and other developed countries. However, people must keep vigilance in maintaining immunization rates and encourage immunization in developing countries. At least one-fifth of congenital cataract is familial. Understanding the genetics of familial cataract will lead to better treatment of congenital as well as age-related cataract.
Assuntos
Catarata/congênito , Catarata/genética , Complicações Infecciosas na Gravidez , Síndrome da Rubéola Congênita/complicações , Catarata/história , Feminino , História do Século XX , Humanos , Gravidez , Síndrome da Rubéola Congênita/históriaRESUMO
BACKGROUND: In 1941, a Sydney ophthalmologist, Norman McAlister Gregg, correctly identified the link between congenital cataracts in infants and maternal rubella early in pregnancy. Fifty of Gregg's subjects with congenital rubella, born in 1939-1944, were reviewed in 1967 and again in 1991. We reviewed this cohort in 2000-2001, 60 years after their intrauterine infection. METHODS: The subjects underwent full clinical assessment, plus pathology tests, an ophthalmological and cardiological review (including electrocardiography and echocardiography) and HLA histocompatibility testing. RESULTS: Since they were first seen in 1967, 10 have died (cardiovascular causes [4], malignant disease [4], AIDS [1], and hepatitis C-related cirrhosis [1]). All surviving men came for review (19) and 13 women (eight women declined). Echocardiography showed mild aortic valve sclerosis in 68%. The prevalence of diabetes (22%), thyroid disorders (19%), early menopause (73%) and osteoporosis (12.5%) was increased compared with the Australian population; 41% had undetectable levels of rubella antibodies. The frequency of HLA-A1 (44%) and HLA-B8 (34%) antigens was increased, and the haplotype HLA-A1, B8, DR3, said to be highly associated with many autoimmune conditions, was present in 25%. CONCLUSIONS: This cohort of people with congenital rubella has illuminated our understanding of viral teratogenesis.