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Background: Parents of children with Congenital Rubella Syndrome (CRS) in rural areas face limited access to medical care and specialised services, financial difficulties, social isolation, and stigma. Research on their experiences is limited. Purpose: This study explores parents' experiences of caring for their children with CRS in rural areas of Indonesia. Methods: The research used a descriptive phenomenological approach, purposive sampling to collect parents of children with CRS from the shelter, and snowball sampling for other participants. Inclusion criteria included parents who cared for CRS children over than two years old, could express their experiences, and spoke Indonesian. Twenty-five parents participated in an in-depth semi-structured interview. The data were analysed using the Colaizzi method. Results: This research found that parents caring for sick children in rural areas experienced life-altering situations that affected their mental health. In addition, caring for sick children also caused emotional disturbances and tension in family life. Other challenges included getting proper treatment for their child, especially in remote rural areas, and difficulty to reach health services. Therefore, proper mental health treatment and support were essential for parents who cared for sick children in rural areas. Conclusion: This study describes complexities of parents' experiences of caring for children with CRS, such as difficulty to accept the child's condition and feeling burdened by their child's case. Further studies are needed to understand cultural influences and expand the study area. [ABSTRACT FROM AUTHOR]

We present a case of a late preterm intrauterine growth-restricted neonate with isolated and persistent severe thrombocytopenia. At birth, the neonate did not have a complete clinical spectrum of congenital rubella syndrome (CRS) but later developed peculiar findings that helped clinch the diagnosis. The neonate also had interstitial pneumonia and died secondary to superimposed acute viral infection leading to acute respiratory distress syndrome. The serology was positive for IgM antibodies against the rubella virus. The constellation of clinical manifestations of congenital rubella in the presence of positive IgM antibody against rubella and consistent histopathology confirmed the diagnosis of CRS.

In 2010, an expert advisory panel convened by the World Health Organization to assess the feasibility of measles eradication concluded that (1) measles can and should be eradicated, (2) eradication by 2020 is feasible if measurable progress is made toward existing 2015 measles mortality reduction targets, (3) measles eradication activities should occur in the context of strengthening routine immunization services, and (4) measles eradication activities should be used to accelerate control and elimination of rubella and congenital rubella syndrome (CRS). The expert advisory panel also emphasized the critical role of research and innovation in any disease control or eradication program. In May 2011, a meeting was held to identify and prioritize research priorities to support measles and rubella/CRS control and potential eradication activities. This summary presents the questions identified by the meeting participants and their relative priority within the following categories: (1) measles epidemiology, (2) vaccine development and alternative vaccine delivery, (3) surveillance and laboratory methods, (4) immunization strategies, (5) mathematical modeling and economic analyses, and (6) rubella/CRS control and elimination.

• Endemic rubella has been eliminated in South Korea since 2011. • A case of suspected congenital rubella syndrome (CRS) was reported in 2017. • CRS was confirmed via rubella-specific IgM and RNA in urine and a throat swab. • Rubella virus, genotype 2b of Vietnamese origin was isolated in a throat swab. • Laboratory surveillance is critical to rubella elimination. The WHO Regional Verification Commission certified in 2017 that Korea was the first country in the WHO Western Pacific Region to achieve rubella elimination. A suspected congenital rubella syndrome (CRS) was reported to the Korea Centers for Disease Control and Prevention in August 2017. The mother of a new-born had visited Vietnam during her pregnancy. CRS was confirmed based on the detection of rubella-specific IgM and rubella RNA in the urine and throat swab. Rubella virus isolated from the throat swab was classified as genotype 2B, and a phylogenetic analysis indicated that this genotype had been imported from Vietnam. This is the first report of CRS confirmed using virus isolation in Korea. Laboratory surveillance plays a critical role in the elimination of rubella through the provision of laboratory testing data, and characterisation of circulating strains. [ABSTRACT FROM AUTHOR]

The name rubella is derived from a Latin expression signifying "minimal red". Rubella is, for the most part, a benign transferable exanthematous disease. It is caused by rubella virus, which is an affiliate of the Rubivirus class of the family Togaviridae. About half of people contaminated with rubella are asymptomatic. Clinical indications and severity of disease fluctuate with age. For example, contamination in children is portrayed by mild constitutional symptoms, suboccipital adenopathy, and rash; on the other hand, in adolescents and adults, rubella might be complicated by arthritis, thrombocytopenic purpura, and arthralgia. Uncommon cases of rubella encephalitis have likewise been depicted in children. The main complication of rubella is its teratogenic impacts when pregnant ladies get the disease, particularly in the early weeks of pregnancy. The virus could be transmitted to the fetus through the placenta and is equipped for causing genuine congenital defects, stillbirths, and abortions. Fortunately, as a consequence of the successful vaccination program, rubella contamination and congenital rubella syndrome infrequently are seen today. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1970, through February 28, 2017. The following search terms were used: rubella, rubella syndrome, congenital, paediatric rubella, vaccination, rubella-containing vaccine, and rubella immunization campaigns. [ABSTRACT FROM AUTHOR]

A estruturação do Sistema Nacional de Vigilância Epidemiológica do Brasil, em 1975, tornou obrigatória a notificação de algumas doenças transmissíveis com o objetivo de reduzir a carga destes eventos no país. Entretanto, as alterações no perfil epidemiológico destas doenças, associadas a características da sociedade contemporânea, determinam a constante adequação das atividades de vigilância a este cenário. Neste manuscrito, são descritos epidemiologia, tendências e diagnóstico diferencial das seguintes doenças dermatológicas de notificação compulsória no Brasil: aids, dengue, hanseníase, leishmaniose tegumentar americana, sarampo, rubéola e síndrome da rubéola congênita e sífilis. Também são apresentados os principais desafios atuais para o controle e prevenção para cada uma dessas doenças no BrasilThe development of a Brazilian National Surveillance System in 1975 led to a compulsory reporting of selected infectious diseases aiming to reduce the burden of these events in the country. However, shifts in the epidemiology of these diseases associated with modern life style, demand constant revision of surveillance activities. In this manuscript we present the epidemiology, trends and differential diagnosis of the following compulsory notifiable diseases in Brazil: Aids, dengue fever, hanseniasis, American tegumentary leishmaniasis, measles, rubella and congenital rubella syndrome and syphilis. Additionally, the current challenges for control and prevention of each disease are presented

The research was aimed at describing the meaning of the rubella vaccine to women who were discovered pregnant after having received the measles-rubella vaccine during the 2001 campaign against rubella, and who lived in 10 cities within the region of DIR XX from São João da Boa Vista. The theory of Social Representation was used as a reference framework for the research, and data were collected through the Collective Subject Discourse technique, involving 18 women who either were pregnant or became pregnant within 30 days after having received the vaccine. Through their discourse, it was possible to unveil the diversity of meanings the rubella vaccine has when dispensed during pregnancy, characterized as a threat to their and their children's physical integrity and to their conjugal relationship. The meanings constitute an important source of information that allows health professionals and administrators to reflect, so they can reconsider their role as health promoters.Se trató de describir el significado de la vacuna contra la rubeola para las mujeres que se enteraron del embarazo después de recibir la vacuna dupla viral, debido a la campaña contra la rubeola-2001, en la DIR XX de São João da Boa Vista. Fue adoptada como referencia la Teoría de la Representaciones Sociales. La colección de datos fue realizada a través de la técnica de Discurso del Sujeto Colectivo con 18 gestantes y mujeres embarazadas hasta 30 días después de la aplicación de la vacuna, consideradas suceptibles a la rubeola, habitantes de 10 municipios de la región. Considerando los discursos de las mujeres, fue posible detectar los diferentes resultados de la vacuna contra la rubeola cuando es aplicada durante la gestación, representada como amenaza a su integridad, a la de su hijo y a su relación conyugal. Esos significados se constituyen en importante fuente de información que brinda a los profesionales de la salud y gestores una reflexión sobre desempeño de su papel como agentes promotores de la salud.Buscou-se descrever o significado da vacina contra rubéola para mulheres que se descobriram grávidas após receberem a vacina dupla viral, por ocasião da campanha contra rubéola-2001, na DIR XX de São João da Boa Vista, SP. Adotou-se como referencial a Teoria das Representações Sociais. A coleta de dados foi realizada através da técnica do Discurso do Sujeito Coletivo com 18 mulheres grávidas e que engravidaram até 30 dias após aplicação da vacina, consideradas suscetíveis à rubéola, residentes em 10 municípios da região. Através dos discursos das mesmas, foi possível desvelar a diversidade de significados da vacina contra a rubéola quando aplicada durante a gravidez, representada como ameaça à sua integridade, à de seu filho e ao seu relacionamento conjugal. Esses significados constituem-se em importante fonte de informação que propicia aos profissionais de saúde e gestores reflexão sobre o seu papel como agentes promotores de saúde.

Introduction & Objective: Despite mild and self limited manifestation of rubella , involvement of fetus as a consequence of prenatal infection is very important and can lead to congenital rubella syndrome (Cs). The aim of this study was the evaluation of immunity rate against rubella virus in women who were in child bearing ages. Materials & Methods: This survey was performed with cooperation of health center on 248 cases of women who are offered for pre marriage serologic test and their titers of IgG antibody against rubella with Elisa method was measured. Results: Out of 248 specimens , 41 (16.5%) were non immune against rubella and 207 (83.5%) were immune. The frequency of immune serologic titer was highest in the age groupof 18-23 years and was lowest in the age group of 30-34 years. Of 138 cases that lived in the urban area, 121 cases (87.7%) were immune and 17 cases (12.3%) were non immune and out of 110 cases that lived in rural areas , 86 cases (78.2%) were immune and 24 cases (21.8%) were non immune. Education level of most women were graduated from high school (50.8%) , whereas the rate of illiterate women was least (1.6%). In this study nobody had a history of vaccination against rubella and 16 cases (6.5%) had a history of rubella infection. Conclusion: On the basis of this study 83.5% of subjects in studied group were immune against rubella and 16.5% were non-immune. This study showed that women in child bearing ages should be checked for rubella and vaccinated against it, if they are non immune.

We report a case of congenital rubella syndrome in a child born to a vaccinated New Jersey woman who had not traveled internationally. Although rubella and congenital rubella syndrome have been eliminated from the United States, clinicians should remain vigilant and immediately notify public health authorities when either is suspected.

OBJECTIVE: To investigate whether the incorporation of rubella vaccine into immunization programmes in developing countries is economically justified. METHODS: A MEDLINE search was conducted for articles published between 1970 and 2000 that dealt with economic analyses of rubella and rubella-containing vaccines. The Eastern Mediterranean, South-East Asia, and Africa regional Index Medicus databases and the LILACS database for Latin America and the Caribbean were also searched. FINDINGS: For developed countries, five cost- benefit analyses of rubella vaccine and five of measles-mumps-rubella vaccine as well as two cost-effectiveness analyses were found. For developing countries, five cost analyses and five cost-benefit analyses were found. All the cost-benefit analyses had a benefit:cost ratio greater than 1 and the cost-effectiveness studies indicated that rubella immunization was a cost-effective means of reducing the impact of congenital rubella syndrome. However, the methodologies were not standardized. CONCLUSION: The data support the inclusion of rubella vaccine in the immunization programmes of both developing and developed countries and indicate economic benefits comparable to those associated with hepatitis B vaccine and Haemophilus influenzae type b vaccine. More studies should be carried out on costs for care and immunization using standardized methodologies and locally obtained information.

Ojective Rubella vaccine is not included in the immunization schedule in Myanmar. Although surveillance for outbreaks of measles and rubella is conducted nationwide, there is no routine surveillance for congenital rubella syndrome (CRS). Therefore, we organized a study to assess the burden of CRS. Methods From 1 December 2000 to 31 December 2002 active surveillance for CRS was conducted among children aged 0-17 months at 13 hospitals and 2 private clinics in Yangon, the capital city. Children with suspected CRS had a standard examination and a blood sample was obtained. All serum samples were tested for rubella-specific IgM; selected samples were tested for rubella-specific IgG and for rubella RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Findings A total of 81 children aged 0-17 months were suspected of having CRS. Of these, 18 children had laboratory-confirmed CRS (7 were IgM positive; 7 were RT-PCR positive; and 10 were IgG positive at ⩾ 6 months of age). One additional child who tested positive by RT-PCR and whose mother had had rubella during pregnancy but who had a normal clinical examination was classified as having congenital rubella infection. During 2001-02 no rubella outbreaks were detected in Yangon Division. In the 31 urban townships of Yangon Division, the annual incidence was 0.1 laboratory-confirmed cases of CRS per 1000 live births. Conclusion This is the first population-based study of CRS incidence from a developing country during a rubella-endemic period; the incidence of CRS is similar to endemic rates found in industrialized countries during the pre-vaccine era. Rubella-specific IgG tests proved practical for diagnosing CRS in children aged ⩾6 months. This is one of the first studies to report on the use of rubella-specific RT-PCR directly on serum samples; further studies are warranted to confirm the utility of this method as an additional means of diagnosing CRS. [ABSTRACT FROM AUTHOR]

The Italian National Plan of Measles and Rubella Elimination 2010-2015 has deferred the objective to reduce congenital rubella syndrome (CRS) to <1 case per 100 000 live births to 2015 and has highlighted the need to reduce to <5% susceptibility to rubella among women in childbearing-age. In Puglia region, MMR vaccine coverage is 93% in newborns (cohort 2010; one dose), 85% in children 5-6 years old and 77% in adolescents (cohort 2005 and 1997, respectively; two doses). Combining available seroepidemiological data and results of a survey on the attitude towards rubella vaccination and rubella testing before pregnancy, we could estimate that 5.7% of Apulian women in childbearing-age are currently susceptible to rubella infection. The regional infectious disease routine notification system reported no cases of CRS and rubella in pregnancy in 2001-2010 period. The inconsistency among the mentioned data triggered the evaluation of the reliability of disease reporting. We performed a retrospective case-finding for the years 2003-2011. We scanned the regional hospital discharge registry to identify hospitalizations for rubella in pregnancy and CRS and retrieve individual records. We also searched for clinical history of CRS mothers in the delivery assistance certificate registry. We identified one CRS, two confirmed and four suspected congenital infections, and seven cases of rubella in pregnancy. Passive surveillance of CRS and rubella in pregnancy appears not to be reliable in the light of strengthening rubella elimination strategies.