Rubella in South Africa : an impending Greek tragedy?

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dc.contributor.author Schoub, Barry D.
dc.contributor.author Harris, Bernice Nerine
dc.contributor.author McAnerney, Johanna M.
dc.contributor.author Blumberg, Lucille H.
dc.date.accessioned 2010-03-17T06:33:48Z
dc.date.available 2010-03-17T06:33:48Z
dc.date.issued 2009-07
dc.description.abstract BACKGROUND: The incidence of congenital rubella syndrome (CRS) is unknown in South Africa. There is evidence that it may be significant and largely undetected, particularly in the upper socio-economic group. This may be due to incomplete routine administration of MMR vaccine in infancy and a build-up of susceptible females reaching the childbearing age group who could be exposed to the extensive reservoir of virus in the unimmunised public sector of the population. OBJECTIVE: To assess the extent of the immunity gap to rubella by testing for protective IgG antibodies and the incidence of rubella infection by testing for IgM antibodies in sera. The data obtained would also be used to model the extent of CRS. DESIGN: Residual laboratory serum specimens from public and private laboratories were serologically tested for rubella IgG antibodies to investigate the immunity gap in the population and IgM antibodies in sera collected from the measles rashlike illness surveillance programme. Modelling exercises calculated the force of infection and the predicted incidence of CRS in South Africa. RESULTS: The serological immunity gap was significantly greater in the private sector specimens compared with the public sector - 10.7% versus 5.4%, respectively. In most years rubella caused much more rash-like illness than measles, with a significant number (5.1 - 9.6%) of rubella-positive IgM specimens occurring in women of childbearing age. CONCLUSION: Modelling of the data suggests that the extent of CRS may be grossly underestimated in South Africa. Approximately 654 cases are calculated to occur every year. It is suggested that selective immunisation of girls before puberty should be instituted together with a routine rubella immunisation programme of infants to forestall a possible future outbreak of CRS, as occurred in Greece in 1993. en
dc.identifier.citation Schoub, BD, Harris, BN, McAnerney, J & Blumberg, L 2009, 'Rubella in South Africa : an impending Greek tragedy?', South African Medical Journal, vol. 99, no. 7, pp. 515-519. [www.samj.org.za] en
dc.identifier.issn 0038-3469
dc.identifier.uri http://hdl.handle.net/2263/13487
dc.language.iso en en
dc.publisher Health and Medical Publishing Group en
dc.rights Health and Medical Publishing Group en
dc.subject Congenital rubella syndrome en
dc.subject Serological immunity gap en
dc.subject.lcsh Rubella -- Immunological aspects en
dc.subject.lcsh Rubella -- Vaccination -- South Africa en
dc.subject.lcsh Genetic disorders in children -- South Africa en
dc.subject.lcsh Immunization of children -- South Africa en
dc.title Rubella in South Africa : an impending Greek tragedy? en
dc.type Article en


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