RESUMO
Since 1814, when rubella was first described, the origins of the disease and its causative agent, rubella virus (Matonaviridae: Rubivirus), have remained unclear1. Here we describe ruhugu virus and rustrela virus in Africa and Europe, respectively, which are, to our knowledge, the first known relatives of rubella virus. Ruhugu virus, which is the closest relative of rubella virus, was found in apparently healthy cyclops leaf-nosed bats (Hipposideros cyclops) in Uganda. Rustrela virus, which is an outgroup to the clade that comprises rubella and ruhugu viruses, was found in acutely encephalitic placental and marsupial animals at a zoo in Germany and in wild yellow-necked field mice (Apodemus flavicollis) at and near the zoo. Ruhugu and rustrela viruses share an identical genomic architecture with rubella virus2,3. The amino acid sequences of four putative B cell epitopes in the fusion (E1) protein of the rubella, ruhugu and rustrela viruses and two putative T cell epitopes in the capsid protein of the rubella and ruhugu viruses are moderately to highly conserved4-6. Modelling of E1 homotrimers in the post-fusion state predicts that ruhugu and rubella viruses have a similar capacity for fusion with the host-cell membrane5. Together, these findings show that some members of the family Matonaviridae can cross substantial barriers between host species and that rubella virus probably has a zoonotic origin. Our findings raise concerns about future zoonotic transmission of rubella-like viruses, but will facilitate comparative studies and animal models of rubella and congenital rubella syndrome.
Assuntos
Mamíferos/virologia , Filogenia , Vírus da Rubéola/classificação , Vírus da Rubéola/isolamento & purificação , Sequência de Aminoácidos , Animais , Animais de Zoológico/imunologia , Animais de Zoológico/virologia , Membrana Celular/virologia , Quirópteros/virologia , Epitopos de Linfócito B/imunologia , Epitopos de Linfócito T/imunologia , Equidae/imunologia , Equidae/virologia , Evolução Molecular , Feminino , Mapeamento Geográfico , Alemanha , Especificidade de Hospedeiro , Humanos , Masculino , Mamíferos/imunologia , Marsupiais/imunologia , Marsupiais/virologia , Fusão de Membrana , Camundongos , Modelos Animais , Modelos Moleculares , Rubéola (Sarampo Alemão)/congênito , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/química , Vírus da Rubéola/imunologia , Alinhamento de Sequência , Uganda , Proteínas do Envelope Viral/químicaRESUMO
Rubella virus causes a mild disease; however, infection during the first trimester of pregnancy may lead to congenital rubella syndrome (CRS) in over 80% of affected pregnancies. Vaccination is recommended and has been shown to effectively reduce CRS incidence. Uganda plans to introduce routine rubella vaccination in 2019. The World Health Organization recommends assessing the disease burden and obtaining the baseline molecular virological data before vaccine introduction. Sera collected during case-based measles surveillance from January 2005 to July 2018 were tested for rubella immunoglobulin M (IgM) antibodies. Sera from confirmed rubella outbreaks from January 2012 to August 2017 were screened using real-time reverse-transcription polymerase chain reaction (RT-PCR); for positive samples, a region within the E1 glycoprotein coding region was amplified and sequenced. Of the 23 196 suspected measles cases serologically tested in parallel for measles and rubella, 5334 (23%) were rubella IgM-positive of which 2710 (50.8%) cases were females with 2609 (96.3%) below 15 years of age. Rubella IgM-positive cases were distributed throughout the country and the highest number was detected in April, August, and November. Eighteen (18%) of the 100 sera screened were real-time RT-PCR-positive of which eight (44.4%) were successfully sequenced and genotypes 1G and 2B were identified. This study reports on the seroprevalence and molecular epidemiology of rubella. Increased knowledge of former and current rubella viruses circulating in Uganda will enhance efforts to monitor the impact of vaccination as Uganda moves toward control and elimination of rubella and CRS.
Assuntos
Anticorpos Antivirais/sangue , Vírus da Rubéola/classificação , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , Adolescente , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Surtos de Doenças/estatística & dados numéricos , Feminino , Genótipo , Humanos , Imunoglobulina M/sangue , Incidência , Masculino , Sarampo/epidemiologia , Filogenia , Gravidez , Vacina contra Rubéola/imunologia , Uganda/epidemiologiaRESUMO
Nucleotide skew analysis is a versatile method to study the nucleotide composition of RNA/DNA molecules, in particular to reveal characteristic sequence signatures. For instance, skew analysis of the nucleotide bias of several viral RNA genomes indicated that it is enriched in the unpaired, single-stranded genome regions, thus creating an even more striking virus-specific signature. The comparison of skew graphs for many virus isolates or families is difficult, time-consuming, and nonquantitative. Here, we present a procedure for a more simple identification of similarities and dissimilarities between nucleotide skew data of coronavirus, flavivirus, picornavirus, and HIV-1 RNA genomes. Window and step sizes were normalized to correct for differences in length of the viral genome. Cumulative skew data are converted into pairwise Euclidean distance matrices, which can be presented as neighbor-joining trees. We present skew value trees for the four virus families and show that closely related viruses are placed in small clusters. Importantly, the skew value trees are similar to the trees constructed by a "classical" model of evolutionary nucleotide substitution. Thus, we conclude that the simple calculation of Euclidean distances between nucleotide skew data allows an easy and quantitative comparison of characteristic sequence signatures of virus genomes. These results indicate that the Euclidean distance analysis of nucleotide skew data forms a nice addition to the virology toolbox.
Assuntos
Composição de Bases , Genoma Viral , RNA Viral/genética , Algoritmos , Animais , Coronavirus/classificação , Coronavirus/genética , HIV-1/classificação , HIV-1/genética , Humanos , Funções Verossimilhança , Conceitos Matemáticos , Modelos Genéticos , Filogenia , Picornaviridae/classificação , Picornaviridae/genética , Vírus da Rubéola/classificação , Vírus da Rubéola/genéticaRESUMO
Although rubella is epidemic in Indonesia, the phylogenetic profile of circulating rubella virus strains has not been clarified. In 2017, rubella virus was detected in 2 travelers who returned from Indonesia to Japan. These strains were classified into genotype 1E lineage 2, which may be an indigenous strain in Indonesia.
Assuntos
Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/diagnóstico , Viagem , Adulto , Diagnóstico Diferencial , Genótipo , Humanos , Indonésia , Japão , Masculino , Filogenia , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/genéticaRESUMO
Rubella is a contagious disease caused by the rubella virus (RuV) that can lead to serious birth defects when women are infected in early pregnancy. This study aimed to describe the epidemiology and genetic diversity of rubella viruses in Cote d'Ivoire (CIV). Blood or oral fluid samples collected from suspected measles cases were first tested for the presence of measles specific IgM antibodies by enzyme-linked immunosorbent assay (ELISA). All measles IgM negative or indeterminate samples were tested for rubella IgM antibody using ELISA. Rubella-IgM-positive samples were tested by real-time reverse transcription polymerase chain reaction (RT-PCR) for the presence of rubella virus RNA. Real-time RT-PCR-positive RNA samples were used as template to amplify the 739 nt region used for rubella genotyping. PCR-positive samples were sequenced and phylogenetic analysis performed. Between 2012 and 2016, 4121 serums and 126 oral fluids were collected through the measles surveillance system. Of these, 3823 and 108 respectively were measles IgM negative or indeterminate. Subsequent testing for rubella found that 690 of 3823 (18%) serum samples and 25 of 108 (23%) oral fluid samples were rubella IgM-positive. The 739 nt segment of the E1 glycoprotein gene was amplified and sequenced for two serums and seven oral fluids samples. Phylogenetic analysis showed that the rubella viruses from CIV belonged to genotypes 1G (eight samples) and 2B (one sample). Rubella virus genotype 2B was found in CIV for the first time. These data contribute to baseline information on rubella virus strains found in CIV before the introduction of rubella vaccine.
Assuntos
Genótipo , Vírus da Rubéola/classificação , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/análise , Sangue/imunologia , Sangue/virologia , Criança , Pré-Escolar , Côte d'Ivoire/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Técnicas de Genotipagem , Humanos , Imunoglobulina M/análise , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/imunologia , Filogenia , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vírus da Rubéola/genética , Análise de Sequência de DNA , Adulto JovemRESUMO
BACKGROUND: The WHO European Region (EUR) has adopted the goal of eliminating measles and rubella but individual countries perform differently in achieving this goal. Measles virus spread across the EUR by mobile groups has recently led to large outbreaks in the insufficiently vaccinated resident population. As an instrument for monitoring the elimination process and verifying the interruption of endemic virus transmission, molecular surveillance has to provide valid and representative data. Irrespective of the country's specific situation, it is required to ensure the functionality of the laboratory surveillance that is supported by the WHO Global Measles and Rubella Laboratory Network. AIMS: To investigate whether the molecular surveillance in the EUR is adequate for the challenges in the elimination phase, we addressed the quality assurance of molecular data, the continuity and intensity of molecular monitoring, and the analysis of transmission chains. SOURCES: Published articles, the molecular External Quality Assessment Programme of the WHO, the Centralized Information System for Infectious Diseases of the WHO EUR and the WHO Measles and Rubella Nucleotide Surveillance databases served as information sources. CONTENT: Molecular proficiency testing conducted by the WHO in 2016 has shown that the expertise for measles and rubella virus genotyping exists in all parts of the EUR. The analysis of surveillance data reported nationally to the WHO in 2013-2016 has revealed some countries with outbreaks but not sufficiently representative molecular data. Long-lasting supranational MV transmission chains were identified. IMPLICATIONS: A more systematic molecular monitoring and recording of the transmission pattern for the whole EUR could help to create a meaningful picture of the elimination process.
Assuntos
Monitoramento Epidemiológico , Vírus do Sarampo/isolamento & purificação , Sarampo/epidemiologia , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Surtos de Doenças , Transmissão de Doença Infecciosa , Europa (Continente)/epidemiologia , Técnicas de Genotipagem/métodos , Técnicas de Genotipagem/normas , Humanos , Ensaio de Proficiência Laboratorial , Sarampo/transmissão , Vírus do Sarampo/classificação , Vírus do Sarampo/genética , Epidemiologia Molecular/métodos , Epidemiologia Molecular/normas , Rubéola (Sarampo Alemão)/transmissão , Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Organização Mundial da SaúdeRESUMO
Recent studies have shown that the currently circulating rubella viruses are mostly members of two genotypes, 1E and 2B. Also, genetically distinct viruses of genotype 1G have been found in East and West Africa. This study used a Mantel test to objectively include both genetic diversity and geographic location in the definition of lineages, and identified statistically justified lineages (n=13) and sub-lineages (n=9) of viruses within genotypes 1G, 1E and 2B. Genotype 2B viruses were widely distributed, while viruses of genotype 1E as well as 1G and 1J were much more geographically restricted. This analysis showed that more precise groupings for rubella viruses are possible, which should improve the ability to track rubella viruses worldwide. A year-by-year analysis revealed gaps in surveillance that need to be resolved in order to support the surveillance needed for enhanced control and elimination goals for rubella.
Assuntos
Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/virologia , Variação Genética , Genótipo , Humanos , FilogeniaRESUMO
Although teratogenic rubella virus (RV) causes a vaccine-preventable disease, it is still endemic in several countries worldwide. Thus, there is a constant risk of RV importation into non-endemic areas. RV monitoring, especially during measles and Zika virus outbreaks, requires reliable diagnostic tools. For this study, a TaqMan-based one-step reverse transcription-quantitative PCR (RT-qPCR) assay, with the p90 gene as a novel and so far unexplored target for detection of clade I and II genotypes, was developed and evaluated. Automated nucleic acid extraction was carried out. Performance characteristics of the TaqMan RT-qPCR assay were determined for a RV plasmid standard and RNA extracted from virus-infected cell culture supernatants representing clade I and II genotypes. Diagnostic specificity and sensitivity were validated against other RNA and DNA viruses, relevant for RV diagnostic approaches and for RV-positive clinical samples, respectively. The assay is specific and highly sensitive with a limit of detection as low as five to one copies per reaction or 200 infectious virus particles per ml. The coefficients of variation (CV) were specified as intra- (within one run) and inter- (between different runs) assay variation, and calculated based on the standard deviations for the obtained Ct values of the respective samples. Intra- and inter-assay CV values were low, with a maximum of 3.4% and 2.4%, respectively. The assay was shown to be suitable and specific for the analysis of clinical samples. With p90 as a novel target, the highly sensitive and specific TaqMan assay outlined in this study is suitable for RV diagnosis worldwide.
Assuntos
RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/diagnóstico , Proteínas Virais/genética , Sequência de Bases , Expressão Gênica , Genótipo , Humanos , Variações Dependentes do Observador , Filogenia , Reação em Cadeia da Polimerase em Tempo Real/normas , Reprodutibilidade dos Testes , Reação em Cadeia da Polimerase Via Transcriptase Reversa/normas , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/isolamento & purificação , Sensibilidade e Especificidade , Alinhamento de SequênciaRESUMO
We wished to study the dynamic change in variation of rubella viruses circulating during 1999-2015 in mainland China at the molecular level. Molecular evolution of Chinese rubella viruses collected during 1999 ~ 2015 was analyzed according to a surveillance database of measles/rubella laboratory networks in China. A total of 1737 rubella viruses were obtained from 20 of 31 provinces (except Xinjiang and Tibet) during 1999 ~ 2015. Four genotypes (1E, IF, 2A, 2B) were detected. The genotype-1E rubella virus was detected first in 2001. Subsequently, genotype 1E became the predominant genotype circulating during 2001~2013, and could be divided into two closely related clusters (A (2004-2015) and B (2001-2009)). However, the detection rate of the genotype-1E rubella virus decreased year-by-year from 2011, and reached the lowest level (1. 3%) in 2015. The genotype-1F rubella virus was restricted geographically to China, and no longer found after 2002; presumably its circulation in China was interrupted. All genotype-2A rubella viruses were derived from vaccine-related cases. At least four genotypes of 2B rubella viruses (lineage 1 ~ 4) circulated in mainland China during 2000 ~ 2015. The genotype-2B rubella virus was detected sporadically and was in a weak position until 2010. However, the detection rate of imported genotype-2B rubella viruses (lineage 3) was increased and became the predominant genotype during 2014~2015. Through the study of 16 consecutive years in mainland China, the evolution and epidemic situation of the rubella virus was obtained to aid virology surveillance for rubella control in China.
Assuntos
Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/virologia , China/epidemiologia , Evolução Molecular , Variação Genética , Genótipo , Humanos , Filogenia , RNA Viral/genética , Rubéola (Sarampo Alemão)/epidemiologia , Vírus da Rubéola/classificação , Vírus da Rubéola/genéticaRESUMO
The National Plan for the Elimination of Rubella was implemented in Spain in 2008 using the logistics of the National Plan for the Elimination of Measles that have been employed since year 2000. Molecular characterization of rubella virus (RUBV) is important for disease surveillance and for monitoring elimination of the disease throughout the world. We describe the first complete series of data regarding the circulation of RUBV genotypes in Spain. The 739-nucleotide fragment designated by the WHO for RUBV genotyping was sequenced in 88 selected cases collected from 1998 to 2014. Five genotypes were identified: 1E, 2B, 1J, 1I, and 1a. Genotype 1E was predominant between 1998 and 2003 but was replaced by genotype 2B, which was detected in sporadic cases in 2004, 2006, 2008, 2012, 2013 and 2014. There was an outbreak of genotype 2B in Algeciras (Andalusia) in 2008. Genotype 1J caused an outbreak in Madrid in 2004/2005 and sporadic cases in 2005 and 2007. Genotype 1I was found to have infected an immune-suppressed patient with neurological symptoms in 2008. Finally, vaccine strain RA 27/3 was detected in three sporadic cases, two of them immune-suppressed and without a recent history of vaccination. This suggests that during these years there were a series of imported sporadic cases and outbreaks, confirming the findings of epidemiological data analysis. The importation sources were generally consistent with our geographic and cultural ties, mainly with Europe (genotypes 1E, 2B, 1I) and Latin America (1J).
Assuntos
Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , Surtos de Doenças , Genótipo , Humanos , Filogenia , Vírus da Rubéola/classificação , Vírus da Rubéola/isolamento & purificação , Espanha/epidemiologiaRESUMO
Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc.
Assuntos
Síndrome da Rubéola Congênita/epidemiologia , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/epidemiologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , República Democrática do Congo/epidemiologia , Feminino , Genótipo , Humanos , Imunoglobulina M/sangue , Lactente , Recém-Nascido , Masculino , Sarampo/diagnóstico , Sarampo/imunologia , Sarampo/virologia , Vírus do Sarampo/imunologia , Pessoa de Meia-Idade , Faringe/virologia , Filogenia , Gravidez , RNA Viral/genética , Rubéola (Sarampo Alemão)/sangue , Rubéola (Sarampo Alemão)/virologia , Síndrome da Rubéola Congênita/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/imunologia , Análise de Sequência de DNA , Proteínas do Envelope Viral/genética , Adulto JovemRESUMO
BACKGROUND: Ocular infections remain a major cause of blindness and morbidity worldwide. While prognosis is dependent on the timing and accuracy of diagnosis, the etiology remains elusive in ~50 % of presumed infectious uveitis cases. The objective of this study is to determine if unbiased metagenomic deep sequencing (MDS) can accurately detect pathogens in intraocular fluid samples of patients with uveitis. METHODS: This is a proof-of-concept study, in which intraocular fluid samples were obtained from five subjects with known diagnoses, and one subject with bilateral chronic uveitis without a known etiology. Samples were subjected to MDS, and results were compared with those from conventional diagnostic tests. Pathogens were identified using a rapid computational pipeline to analyze the non-host sequences obtained from MDS. RESULTS: Unbiased MDS of intraocular fluid produced results concordant with known diagnoses in subjects with (n = 4) and without (n = 1) uveitis. Samples positive for Cryptococcus neoformans, Toxoplasma gondii, and herpes simplex virus 1 as tested by a Clinical Laboratory Improvement Amendments-certified laboratory were correctly identified with MDS. Rubella virus was identified in one case of chronic bilateral idiopathic uveitis. The subject's strain was most closely related to a German rubella virus strain isolated in 1992, one year before he developed a fever and rash while living in Germany. The pattern and the number of viral identified mutations present in the patient's strain were consistent with long-term viral replication in the eye. CONCLUSIONS: MDS can identify fungi, parasites, and DNA and RNA viruses in minute volumes of intraocular fluid samples. The identification of chronic intraocular rubella virus infection highlights the eye's role as a long-term pathogen reservoir, which has implications for virus eradication and emerging global epidemics.
Assuntos
Cryptococcus neoformans/genética , Herpesvirus Humano 1/genética , Metagenômica , Vírus da Rubéola/genética , Toxoplasma/genética , Uveíte/diagnóstico , Humor Aquoso/microbiologia , Humor Aquoso/parasitologia , Humor Aquoso/virologia , Criptococose/diagnóstico , Criptococose/microbiologia , Cryptococcus neoformans/patogenicidade , Herpes Simples/diagnóstico , Herpes Simples/virologia , Herpesvirus Humano 1/patogenicidade , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Filogenia , Rubéola (Sarampo Alemão)/diagnóstico , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/patogenicidade , Toxoplasma/patogenicidade , Toxoplasmose/diagnóstico , Toxoplasmose/parasitologia , Úvea/microbiologia , Úvea/parasitologia , Úvea/patologia , Úvea/virologia , Uveíte/microbiologia , Uveíte/parasitologia , Uveíte/virologia , Replicação ViralRESUMO
BACKGROUND: An estimated 100,000 cases of congenital rubella syndrome (CRS) occur worldwide each year. The reported mortality rate for infants with CRS is up to 33%. The cellular mechanisms responsible for the multiple congenital defects in CRS are presently unknown. Here we identify cell types positive for rubella virus (RV) in CRS infants. METHODS: Cells and organs involved in RV replication were identified in paraffin-embedded autopsy tissues from three fatal case-patients by histopathologic examination and immunohistochemical (IHC) staining using a rabbit polyclonal RV antibody. Normal rabbit antisera and RV antisera preabsorbed with highly purified RV served as negative controls. RESULTS: RV antigen was found in interstitial fibroblasts in the heart, adventitial fibroblasts of large blood vessels, alveolar macrophages, progenitor cells of the outer granular layer of the brain, and in capillary endothelium and basal plate in the placenta. The antibody specificity was verified by IHC staining of multiple tissue sections from other infectious disease cases. RV infection of each cell type is consistent with abnormalities which have been identified in patients with CRS, in the heart, large blood vessels, and brain. Antigen distribution was consistent with inflammatory response to vascular injury and systemic spread of RV. CONCLUSIONS: The identification of RV positive cell types in CRS is important to better understand the pathology and pathogenesis of CRS.
Assuntos
Antígenos Virais/imunologia , Síndrome da Rubéola Congênita/imunologia , Síndrome da Rubéola Congênita/virologia , Vírus da Rubéola/imunologia , Autopsia , Biópsia , Linhagem Celular , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/patologia , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Pulmão/imunologia , Pulmão/patologia , Pulmão/virologia , Masculino , Miocárdio/imunologia , Miocárdio/patologia , Gravidez , Síndrome da Rubéola Congênita/diagnóstico , Síndrome da Rubéola Congênita/transmissão , Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Replicação ViralRESUMO
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
BACKGROUND: Many cases of Fuchs' uveitis have been associated with persistent rubella virus infection. A 73-year-old male patient with typical Fuchs' Uveitis Syndrome (FUS) first experienced heterochromia of the left eye at the age fourteen, when rubella was endemic in the US. OBJECTIVES: The purposes of this report are to describe the patient's FUS clinical presentations and to characterize the virus detected in the vitreous fluid. STUDY DESIGN: The patient underwent a therapeutic pars plana vitrectomy in May 2013. A real-time RT-PCR assay for rubella virus was performed on the vitreous fluid by Focus Diagnostics. Additional real-time RT-PCR assays for rubella virus detection and RT-PCR assays for generation of templates for sequencing were performed at the Centers for Disease Control and Prevention (CDC). RESULTS: The results from Focus Diagnostics were positive for rubella virus RNA. Real-time RT-PCR assays at CDC were also positive for rubella virus. A rubella virus sequence of 739 nucleotides was determined and phylogenetic analysis showed that the virus was the sole member of a new phylogenetic group when compared to reference virus sequences. CONCLUSIONS: While FUS remains a clinical diagnosis, findings in this case support the association between rubella virus and the disease. Phylogenetic analysis provided evidence that this rubella virus was likely a previously undetected genotype which is no longer circulating. Since the patient had rubella prior to 1955, this sequence is from the earliest rubella virus yet characterized.
Assuntos
Infecções Oculares Virais/virologia , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/diagnóstico , Uveíte/complicações , Idoso , Infecções Oculares Virais/complicações , Distrofia Endotelial de Fuchs/complicações , Genótipo , Humanos , Masculino , Filogenia , RNA Viral/análise , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Uveíte/virologiaRESUMO
A large rubella outbreak has been observed since June 2012 in Tokyo, Japan, and a rapid increase in the number of congenital rubella syndrome (CRS) cases have also been reported in Japan since October 2012. All the clinically diagnosed and laboratory-confirmed rubella cases reported in Tokyo from January 2012 to December 2013 and all the laboratory-confirmed CRS cases from January 2012 to March 2014 were analyzed. In total, 4,116 rubella cases were reported in Tokyo. Of these, 77.2% (n=3,176) were male; the highest number of cases occurred in males aged 35-39 years and in females aged 20-24 years. Complications included arthralgia/arthritis (19.4%), thrombocytopenic purpura (0.5%), hepatic dysfunction (0.3%), and encephalitis (0.1%). The circulating rubella virus in Tokyo was genotype 2B. The most possible site of transmission was the workplace. Because of the rubella epidemic, 16 CRS cases were reported in Tokyo from March 2013 to February 2014. Domestic infection with rubella was proven for all mothers of 16 cases. This situation suggests that Japan is still working to achieve rubella elimination.
Assuntos
Surtos de Doenças , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/patologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Artralgia/epidemiologia , Criança , Pré-Escolar , Encefalite Viral/epidemiologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Hepatopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Púrpura Trombocitopênica/epidemiologia , Rubéola (Sarampo Alemão)/complicações , Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Distribuição por Sexo , Tóquio/epidemiologia , Adulto JovemRESUMO
Rubella remains a significant burden in mainland China. In this report, 667 viruses collected in 24 of 31 provinces of mainland China during 2010-2012 were sequenced and analyzed, significantly extending previous reports on limited numbers of viruses collected before 2010. Only viruses of genotypes 1E and 2B were found. Genotype 1E viruses were found in all 24 provinces. Genotype 1E viruses were likely introduced into mainland China around 1997 and endemic transmission of primarily one lineage became established. Viruses reported here from 2010-2012 are largely in a single cluster within this lineage. Genotype 2B viruses were rarely detected in China prior to 2010. This report documents a previously undetected 2B lineage, which likely became endemic in eastern provinces of China between 2010 and 2012. Bayesian analyses were performed to estimate the evolutionary rates and dates of appearance of the genotype 1E and 2B viral linages in China. A skyline plot of viral population diversity did not provide evidence of reduction of diversity as a result of vaccination, but should be useful as a baseline for such reductions as vaccination programs for rubella become widespread in mainland China.
Assuntos
Evolução Molecular , Genótipo , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , China/epidemiologia , Variação Genética , Geografia , Humanos , Incidência , Filogenia , RNA Viral/genética , Vírus da Rubéola/classificação , Vírus da Rubéola/isolamento & purificação , Análise de Sequência de DNA , Proteínas do Envelope Viral/genéticaRESUMO
Rubella virus (RV) infection is an unresolved clinical complication that affects children in developing countries including Vietnam. RV infection during the first trimester of pregnancy causes severe birth defects known as congenital rubella syndrome. This study reports on the genomic characterization of RV strains circulating in northern Vietnam during 2011-2013. RV-IgM positive amniotic fluid specimens were collected from 38 women from northern Vietnam who presented with clinical rubella at the National Hospital of Obstetrics and Gynecology in Hanoi, Vietnam. The RV genes were determined by nested PCR with primers amplifying the 739-nucleotide coding region of the E1 gene. The sequences from the amplified DNA fragments were phylogenetically analyzed and compared to reference RV strains. Seventeen out of 38 samples are positive for RV detecting. All new RV isolates are clustered to genotype 2B. Eighteen amino acid mutations were found in the T and B cell epitopes. These results suggest that genotype 2B RV strains frequently circulate in northern Vietnam. These data describe the RV genotype in Vietnam with the aim of improving maternal and child health in this country.
Assuntos
Complicações Infecciosas na Gravidez/virologia , Vírus da Rubéola/classificação , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/virologia , Análise por Conglomerados , Feminino , Genótipo , Humanos , Epidemiologia Molecular , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Rubéola (Sarampo Alemão)/epidemiologia , Vírus da Rubéola/isolamento & purificação , Análise de Sequência de DNA , Vietnã/epidemiologia , Proteínas do Envelope Viral/genéticaRESUMO
Between July 2012 and March 2013, a total of 133 clinical specimens from 47 patients suspected of having measles were collected for virological surveillance in Aichi Prefecture, Japan. Facing the rubella epidemic, the reverse transcription (RT)-PCR protocol for measles virus (MeV) was modified to simultaneously detect rubella virus (RUBV) in these clinical specimens. As a result, 30 specimens from 15 patients were positive for RUBV and 8 specimens from 3 patients were positive for MeV. The RUBV genotype analysis for the samples from 13 patients revealed 12 samples as 2B and 1 sample as 1E. The results provided additional evidence for the difficulty in the diagnosis of exanthematous diseases based on clinical manifestations alone and the necessity of virological diagnosis to maintain the accuracy of case-based surveillance. Furthermore, the results indicated that the modified RT-PCR protocol could be useful as a routine procedure to simultaneously detect MeV and RUBV in clinical specimens of patients suspected of having exanthematous disease caused by these viruses.