Follow-up study of unknowingly pregnant women vaccinated against rubella in Brazil, 2001-2002.

BACKGROUND: Brazil conducted mass immunization of women of childbearing age in 2001 and 2002. Surveillance was initiated for vaccination of women during pregnancy to monitor the effects of rubella vaccination on fetal outcomes. METHODS: Women vaccinated while pregnant or prior to conception were reported to the surveillance system. Susceptibility to rubella infection was determined by anti-rubella immunoglobulin (Ig) M and IgG immunoassays. Susceptible women were observed through delivery. Live-born infants were tested for anti-rubella IgM antibody; IgM-seropositive newborns were tested for viral shedding and observed for 12 months for signs of congenital rubella syndrome. Incidence of congenital rubella infection was calculated using data from 7 states. RESULTS: A total of 22 708 cases of rubella vaccination during pregnancy or prior to conception were reported nationwide, 20,536 (90%) of which were from 7 of 27 states in Brazil. Of these, 2332 women were susceptible to rubella infection at vaccination. Sixty-seven (4.1%) of 1647 newborns had rubella IgM antibody (incidence rate, 4.1 congenital infections per 100 susceptible women vaccinated during pregnancy [95% confidence interval, 3.2-5.1]). None of the infants infected with rubella vaccine virus was born with congenital rubella syndrome. CONCLUSIONS: As rubella elimination goals are adopted worldwide, evidence of rubella vaccine safety aids in planning and implementation of mass adult immunization.

A mortalidade infantil e a atuação dos Comitês nos municípios do Litoral Norte de São Paulo de 2003 a 2012 / Infant mortality and the role of the Committees in the cities of the North Coast of São Paulo from 2003 to 2012

A partir da década de 90, O Sistema Único de Saúde brasileiro passou a incentivar a criação dos Comitês Municipais de Investigação da Mortalidade Materna e Infantil (CMMI) visando: qualificar os sistemas de informação; melhorar a assistência à saúde; subsidiar políticas e reduzir as taxas de mortalidade materna e infantil...

A mortalidade infantil e a atuação dos Comitês nos municípios do Litoral Norte de São Paulo de 2003 a 2012 / Infant mortality and the role of the Committees in the cities of the North Coast of São Paulo from 2003 to 2012

A partir da década de 90, O Sistema Único de Saúde brasileiro passou a incentivar a criação dos Comitês Municipais de Investigação da Mortalidade Materna e Infantil (CMMI) visando: qualificar os sistemas de informação; melhorar a assistência à saúde; subsidiar políticas e reduzir as taxas de mortalidade materna e infantil...