Re-verifying the elimination of measles, rubella and congenital rubella syndrome in Canada, 2016–2020

Elimination, in the context of measles, rubella and congenital rubella syndrome (CRS), refers to the absence of endemic measles/rubella virus transmission in a region or other defined geographic area for at least 12 months, in the presence of a high-quality surveillance system that meets targets of key performance indicators. In 1994, Canada and other countries of the World Health Organization (WHO) region of the Americas committed to the objectives of measles elimination by 2000 and rubella and CRS by 2010. Canada met these targets: eliminating measles transmission in 1998; rubella transmission in 2005; and endemically-acquired CRS in 2000. The WHO region of Americas was declared free of endemic rubella/CRS in 2015 and endemic measles in 2016. At the request of the Pan American Health Organization (PAHO), Canada’s elimination status of measles, rubella and CRS was verified in 2012 and again in 2017. Prior to submission to PAHO, the verification reports were reviewed, approved and endorsed by Canada’s National Certification Committee (NCC). The NCC is a group of experts who are not directly involved with the management of vaccine preventable diseases or immunization program implementation at the national level, but who have the expertise to assist in ensuring that Canada is meeting PAHO’S goals of elimination and eradication. Members are responsible for reviewing Canada’s current mechanisms of surveillance and progress towards elimination of targeted vaccine preventable diseases in Canada. Members have expertise in the fields of public health, infectious diseases and/or laboratory sciences.

Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019–20

Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting children aged between 9 months to <15 years and established a hospital-based sentinel surveillance for CRS. Reliable data about incidence of CRS is necessary to monitor progress towards the elimination goal. Methods We conducted serosurveys in 2019–20 among pregnant women attending antenatal clinics of 6 hospitals, which were also sentinel sites for CRS surveillance, to estimate the prevalence of IgG antibodies against rubella. We systematically sampled 1800 women attending antenatal clinics and tested their sera for IgG antibodies against rubella. We used rubella seroprevalence data from the current survey and the survey conducted in 2017 among antenatal women from another 6 CRS surveillance sites to construct a catalytic models to estimate the incidence and burden of CRS. Result The seroprevalence of rubella antibodies was 82.3% (95% CI: 80.4–84.0). Rubella seropositivity did not differ by age group and educational status. Based on the constant and age-dependent force of infection models, we estimated that the annual incidence of CRS in India was 225.58 per 100,000 live births (95% CI: 217.49–232.41) and 65.47 per 100,000 live births (95% CI: 41.60–104.16) respectively. This translated to an estimated 14,520 (95% CI: 9,225–23,100) and 50,028 (95% CI: 48,234–51,543) infants with CRS every year based on age-dependent and constant force of infection models respectively. Conclusions Our findings indicated that about one fifth of women in the reproductive age group in India were susceptible for rubella. The estimates of CRS incidence will serve as a baseline to monitor the impact of MRCV SIAs, as well progress towards the elimination goal of rubella/CRS.

Anaesthetic Management of a Child with Congenital Rubella Syndrome Posted for Cochlear Implant - A Case Report

Congenital Rubella Syndrome (CRS) is a constellation of multi-system abnormalities and each problem has significant anaesthetic implications. These patients pose various challenge to anesthesiologists like unanticipated difficult airway, uncorrected cardiac lesions, etc. Anesthetic for cochlear implant in child with CRS has not been reported. Anaesthetic management in an infant with PS should be based on decrease in pulmonary vascular resistance (PVR), avoidance of tachycardia with sinus rhythm, myocardial depression, systemic hypotension and adequate intra vascular volume. Here we report the anaesthetic management of a 5 year aged child with congenital rubella syndrome - post device closure of Patent ductus arteriosus, bilateral cataract surgery with moderate branch pulmonary artery stenosis and mental retardation posted for cochlear implant. Keywords: Congenital rubella syndrome, pulmonary artery stenosis, difficult airway, cochlear implant, patent ductus arteriosus.

EDUKASI PEMBERIAN IMUNISASI MR (MEASLES RUBELLA) PADA IBU YANG MEMILIKI ANAK USIA BALITA

Campak dan Rubella merupakan penyakit infeksi menular melalui saluran nafas yang disebabkan oleh virus Campak dan Rubella.Vaksin MR (Measles Rubella) memberikan manfaat seperti dapat melindungi anak dari kecacatan dan kematian akibat komplikasi pneumonia, diare, kerusakan otak, ketulian, kebutaan, dan penyakit jantung bawaan. Indonesia telah berkomitmen untuk mencapai eliminasi campak dan pengendalian rubella/Congenital Rubella Syndrome (CRS) pada tahun 2020. Berdasarkan hasil surveilans dan cakupan imunisasi, maka imunisasi campak rutin saja belum cukup untuk mencapai target eliminasi campak. Sedangkan untuk akselerasi pengendalian rubella/CRS maka perlu dilakukan kampanye imunisasi tambahan sebelum introduksi vaksin MR ke dalam imunisasi rutin. Program Pengabdian Masyarakat ini melalui penerapan Ipteks bagi masyarakat bertujuan mengenalkan dan tercapainya cakupan imunisasi measles rubella. Kegiatan pengabmas dilaksanakan hari Rabu tanggal 18 Februari 2021 pukul 10.00 Wib, tempat pelaksanaan di Puskesmas Nanggalo Padang. Peserta yang hadir jumlah 15 orang ibu-ibu yang mempunyai anak usia balita. Berdasarkan hasil kegiatan tersebut terjadinya peningkatan pengetahuan ibu yang mempunyai anak usia balita tentang pemberian imunisasi MR. Diharapkan petugas kesehatan meningkatkan edukasi tentang pemberian imunisasi MR. Kata Kunci: Imunisasi MR (Measles Rubella) ABSTRACT Measles and Rubella are infectious diseases that are transmitted through the respiratory tract caused by the measles and rubella viruses. The MR (Measles Rubella) vaccine provides benefits such as protecting children from disability and death due to complications of pneumonia, diarrhea, brain damage, deafness, blindness and heart disease. built-in. Indonesia has committed to achieve elimination of measles and control of rubella / Congenital Rubella Syndrome (CRS) by 2020. Based on the results of surveillance and immunization coverage, routine measles immunization alone is not sufficient to achieve the target of measles elimination. Meanwhile, for the acceleration of rubella / CRS control, it is necessary to carry out an additional immunization campaign before the introduction of the MR vaccine into routine immunization. This Community Service Program through the application of science and technology for the community aims to introduce and achieve measles rubella immunization coverage. Community service activities will be carried out on Wednesday, February 18, 2021 at 10.00 WIB, the place of implementation is at the Nanggalo Padang Health Center. Participants who attended were 15 mothers who have children under five. Based on the results of these activities there is an increase in the knowledge of mothers who have children aged under five about giving MR immunization. It is hoped that health workers will increase education about MR immunization. Keywords: immunization MR (Measles Rubella)Campak dan Rubella merupakan penyakit infeksi menular melalui saluran nafas yang disebabkan oleh virus Campak dan Rubella.Vaksin MR (Measles Rubella) memberikan manfaat seperti dapat melindungi anak dari kecacatan dan kematian akibat komplikasi pneumonia, diare, kerusakan otak, ketulian, kebutaan, dan penyakit jantung bawaan. Indonesia telah berkomitmen untuk mencapai eliminasi campak dan pengendalian rubella/Congenital Rubella Syndrome (CRS) pada tahun 2020. Berdasarkan hasil surveilans dan cakupan imunisasi, maka imunisasi campak rutin saja belum cukup untuk mencapai target eliminasi campak. Sedangkan untuk akselerasi pengendalian rubella/CRS maka perlu dilakukan kampanye imunisasi tambahan sebelum introduksi vaksin MR ke dalam imunisasi rutin. Program Pengabdian Masyarakat ini melalui penerapan Ipteks bagi masyarakat bertujuan mengenalkan dan tercapainya cakupan imunisasi measles rubella. Kegiatan pengabmas dilaksanakan hari Rabu tanggal 18 Februari 2021 pukul 10.00 Wib, tempat pelaksanaan di Puskesmas Nanggalo Padang. Peserta yang hadir jumlah 15 orang ibu-ibu yang mempunyai anak usia balita. Berdasarkan hasil kegiatan tersebut terjadinya peningkatan pengetahuan ibu yang mempunyai anak usia balita tentang pemberian imunisasi MR. Diharapkan petugas kesehatan meningkatkan edukasi tentang pemberian imunisasi MR. Kata Kunci: Imunisasi MR (Measles Rubella) ABSTRACT Measles and Rubella are infectious diseases that are transmitted through the respiratory tract caused by the measles and rubella viruses. The MR (Measles Rubella) vaccine provides benefits such as protecting children from disability and death due to complications of pneumonia, diarrhea, brain damage, deafness, blindness and heart disease. built-in. Indonesia has committed to achieve elimination of measles and control of rubella / Congenital Rubella Syndrome (CRS) by 2020. Based on the results of surveillance and immunization coverage, routine measles immunization alone is not sufficient to achieve the target of measles elimination. Meanwhile, for the acceleration of rubella / CRS control, it is necessary to carry out an additional immunization campaign before the introduction of the MR vaccine into routine immunization. This Community Service Program through the application of science and technology for the community aims to introduce and achieve measles rubella immunization coverage. Community service activities will be carried out on Wednesday, February 18, 2021 at 10.00 WIB, the place of implementation is at the Nanggalo Padang Health Center. Participants who attended were 15 mothers who have children under five. Based on the results of these activities there is an increase in the knowledge of mothers who have children aged under five about giving MR immunization. It is hoped that health workers will increase education about MR immunization. Keywords: immunization MR (Measles Rubella)

Congenital Rubella Syndrome among Hospitalised Infants in South India - A Long Way to Go

BACKGROUND The prevalence of rubella immunity in India is 55 % in pregnant women during the first 3 months of pregnancy and nearly 45 % of women are susceptible to congenital rubella syndrome. The exact epidemiology or actual burden of congenital rubella syndrome has not yet been assessed in the Indian population. In the run up to the target of controlling congenital rubella by 2020, there is added impetus to document congenital rubella syndrome cases, its clinical characteristics, interventions needed and psychosocial problems of infants and their parents, admitted with laboratory confirmed congenital rubella syndrome. METHODS A retrospective study based on hospital records was conducted between January 2016 and December 2017. Clinically confirmed cases not satisfying laboratory criteria for congenital rubella syndrome were excluded. In-depth interviews of mothers were conducted. RESULTS 16 infants with a positive IgM rubella antibody were included. Microcephaly was observed in 9 (56 %) babies. Ophthalmological manifestations were present in 12 (75 %) babies; of whom 9 (75 %) had cataract. Glaucoma occurred in 3 (18 %) babies and 2 (12.5 %) had salt and pepper retinopathy. Hearing impairment was detected in 8 (50 %) babies. Congenital heart disease was present in 15 (93.7 %) infants. Surgical interventions including cataract surgery, patent ductus arteriosus ligation and cochlear implantation were necessary in 14 babies. CONCLUSIONS Congenital rubella syndrome is still a significant problem and urgent measures are needed to increase immunisation coverage of the target population. Affected families endure a heavy physical and psychosocial burden, which should be addressed simultaneously. KEYWORDS Congenital Rubella Syndrome, Rubella Vaccination, Cataracts

PEMODELAN DINAMIKA VIRUS RUBELLA DENGAN RISIKO SINDROM RUBELLA BAWAAN

Rubella is a common cause of childhood rash and fever. It is typically a mild infection but it can be serious condition in pregnant women, as it may cause Congenital Rubella Syndrome (CRS) in the fetus. The study aimed to model and analyze it in order to get picture about the dynamics of the rubella virus transmission. The paper discussed two models of rubella transmission involving child-bearing age women and newly born infants of infected mothers. The models are SEIR-IR without seasonality and SEIR-IR with seasonality. The results from the first model showed that a pitchfork bifurcation occurred in the dynamics of the solution of the system with constant infection rate and the increase of the infection rate value do not make impact to the incidence of rubella among infants. The second model involving seasonality gave interesting dynamics where big seasonality may lead to a more complex dynamics of the solution.

Rubella — what is the danger of this disease?

Rubella, along with toxoplasmosis, cytomegalovirus and herpes, belongs to TORCH infections, diseases that can have a detrimental effect on the fetus if infected during pregnancy. The disease is caused by a virus, the only known source and carrier of which is human. Mostly children and young people are susceptible to the disease; they tolerate the disease quite easily. Of the clinical symptoms, it should be noted the appearance of a rash, a slight increase in temperature, regional lymphadenitis, and sometimes conjunctivitis. In adults, joint inflammation can also occur, which usually lasts 3–7 days. The rubella virus is most dangerous when a woman first becomes infected during pregnancy, especially in the first trimester. The probability of intrauterine infection of the fetus in this situation is 90 %, as a result of which it may die or develop congenital rubella syndrome (CRS). As a result, children with congenital rubella syndrome can suffer from developmental defects, hearing and visual impairments, diabetes mellitus and thyroid disorders. To prevent intrauterine infection of the fetus, vaccination against rubella is carried out, which leads to the development of stable immunity. Today rubella vaccination is carried out in 168 countries of the world, which allows immunization coverage of about 70 % of women. The countries of the African continent and Southeast Asia are the least affected by rubella vaccination, as a result of which there are about 4 cases of births of children in utero infected with the virus per 1000 births.