Seroepidemiological profile of pregnant women after inadvertent rubella vaccination in the state of Rio de Janeiro, Brazil, 2001-2002 Perfil seroepidemiológico de embarazadas después de recibir inadvertidamente la vacuna antirrubeólica, estado de Rio de Janeiro, Brasil, 2001-2002

OBJECTIVES: To analyze postvaccination serological status in pregnant women inadvertently vaccinated against rubella in the state of Rio de Janeiro, Brazil. METHODS: This was a cross-sectional study of pregnant women 15 to 29 years old, vaccinated against rubella and measles from November 2001 to March 2002, who were unaware of their pregnancy at the time of vaccination or who became pregnant within 30 days thereafter. They were tested for rubella-specific immunoglobulin M (IgM) and G (IgG) and classified as immune (IgM-negative, IgG-positive, tested within 30 days after vaccination), susceptible (IgM-positive after vaccination) or indeterminate (IgM-negative, IgG-positive, vaccination- serological testing interval greater than 30 days). RESULTS: Of 2 292 women, 288 (12.6%) were susceptible, 316 (13.8%) immune, 1 576 (68.8%) indeterminate, 8 (0.3%) ineligible, and 104 (4.5%) lost to follow-up. IgM seropositivity by vaccination-serological testing interval was 16.1% (d" 30 days), 15.4% (30-60 days), and 14.2% (61-90 days). Considering the campaign's target age, the 20-to-24-year age group had the largest proportion of individuals susceptible to rubella (14.8%) and represented 42.4% (122/288) of all susceptible women. In 75% of susceptible pregnant women, gestational age was 5 weeks or less at the time of vaccination. CONCLUSIONS: Mass immunization of childbearing-age women was justified on the basis of epidemiological and serological data. Follow-up of vaccinated pregnant women revealed no cases of congenital rubella syndrome due to rubella vaccination. However, the observed rate of congenital infection supports the recommendation to avoid vaccinating pregnant women, and to avoid conception for up to 1 month following rubella vaccination.<br>OBJETIVOS: Analizar el estado serológico de mujeres embarazadas tras haber recibido inadvertidamente la vacuna antirrubeólica, en el estado de Rio de Janeiro, Brasil. MÉTODOS: Se realizó un estudio transversal de mujeres embarazadas de 15 a 29 años de edad que fueron vacunadas contra la rubéola y el sarampión entre noviembre de 2001 y marzo de 2002 y que no sabían que estaban embarazadas en ese momento o que concibieron en el transcurso de los siguientes 30 días. Se les aplicaron las pruebas detectoras de inmunoglobulina M (IgM) e inmunoglobulina G (IgG) contra el virus de la rubéola y se les clasificó de inmunes si se obtenían resultados negativos a IgM y positivos a IgG al aplicar las pruebas en un lapso no mayor de 30 días después de la vacunación; de susceptibles si se obtenía un resultado positivo a IgM después de la vacunación, o indefinido si se obtenían resultados negativos a IgM y positivos a IgG tras un intervalo mayor de 30 días entre la vacunación y la aplicación de las pruebas serológicas. RESULTADOS: De 2 292 mujeres, 288 (12,6%) se mostraron susceptibles; 316 (13,8%) se mostraron inmunes; 1 576 (68,8%) tuvieron resultados indefinidos; 8 (0,3%) tuvieron resultados ilegibles y 104 (4,5%) no tuvieron seguimiento. La seropositividad a IgM, según el intervalo transcurrido entre la vacunación y la aplicación de las pruebas serológicas, fue de 16,1% (< 30 días), 15,4% (31-60 días), y 14,2% (61-90 días). En lo respectivo a la edad de las personas a las que se dirigió la campaña, se encontró que el grupo de 20 a 24 años tenía la mayor proporción de personas susceptibles a la rubéola (14,8%) y representaba a 42,4% (122/288) de todas las mujeres susceptibles. En 75% de las embarazadas susceptibles, la edad gestacional fue de 5 semanas o menos en el momento de la vacunación. CONCLUSIONES: Se justificó la vacunación poblacional de todas las mujeres en edad fecunda sobre la base de datos epidemiológicos y serológicos. Durante el seguimiento de las embarazadas no se observó ningún caso de síndrome de rubéola congénita ocasionado por la vacuna antirrubeólica. No obstante, el porcentaje de infección congénita observado refuerza la recomendación de que se evite vacunar a mujeres embarazadas y de que estas procuren no concebir durante un mes como mínimo después de la vacunación antirrubeólica

Seroepidemiological profile of pregnant women after inadvertent rubella vaccination in the state of Rio de Janeiro, Brazil, 2001–2002

Submitted by Sandra Infurna ([email protected]) on 2019-07-16T10:47:12Z No. of bitstreams: 1 DaiseAFerreira_MarilsaSiqueira_etal_IOC_2006.pdf: 112047 bytes, checksum: c604a9c9c8beef8c258f5782b9e3ac47 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-07-16T10:55:14Z (GMT) No. of bitstreams: 1 DaiseAFerreira_MarilsaSiqueira_etal_IOC_2006.pdf: 112047 bytes, checksum: c604a9c9c8beef8c258f5782b9e3ac47 (MD5)Made available in DSpace on 2019-07-16T10:55:15Z (GMT). No. of bitstreams: 1 DaiseAFerreira_MarilsaSiqueira_etal_IOC_2006.pdf: 112047 bytes, checksum: c604a9c9c8beef8c258f5782b9e3ac47 (MD5) Previous issue date: 2006Secretaria de Estado de Saúde. Centro de Vigilância Epidemiológica. Assessoria de Doenças Imunopreveníveis. Vigilância das Doenças Exantemáticas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Virologia. Laboratório de Vírus Respiratórios e Sarampo. Rio de Janeiro, RJ, Brasil.Secretaria de Estado de Saúde. Centro de Vigilância Epidemiológica. Assessoria de Doenças Imunopreveníveis. Vigilância das Doenças Exantemáticas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Virologia. Laboratório de Vírus Respiratórios e Sarampo. Rio de Janeiro, RJ, Brasil.Objectives. To analyze postvaccination serological status in pregnant women inadvertently vaccinated against rubella in the state of Rio de Janeiro, Brazil. Methods. This was a cross-sectional study of pregnant women 15 to 29 years old, vaccinated against rubella and measles from November 2001 to March 2002, who were unaware of their pregnancy at the time of vaccination or who became pregnant within 30 days thereafter. They were tested for rubella-specific immunoglobulin M (IgM) and G (IgG) and classified as immune (IgM-negative, IgG-positive, tested within 30 days after vaccination), susceptible (IgM-positive after vaccination) or indeterminate (IgM-negative, IgG-positive, vaccination–serological testing interval greater than 30 days). Results. Of 2 292 women, 288 (12.6%) were susceptible, 316 (13.8%) immune, 1 576 (68.8%) indeterminate, 8 (0.3%) ineligible, and 104 (4.5%) lost to follow-up. IgM seropositivity by vaccination–serological testing interval was 16.1% (≤ 30 days), 15.4% (30–60 days), and 14.2% (61–90 days). Considering the campaign’s target age, the 20-to-24-year age group had the largest proportion of individuals susceptible to rubella (14.8%) and represented 42.4% (122/288) of all susceptible women. In 75% of susceptible pregnant women, gestational age was 5 weeks or less at the time of vaccination. Conclusions. Mass immunization of childbearing-age women was justified on the basis of epidemiological and serological data. Follow-up of vaccinated pregnant women revealed no cases of congenital rubella syndrome due to rubella vaccination. However, the observed rate of congenital infection supports the recommendation to avoid vaccinating pregnant women, and to avoid conception for up to 1 month following rubella vaccination

Prevalência de anticorpos contra o vírus do sarampo após campanha de vacinação em massa em Niterói, Estado do Rio de Janeiro, Brasil

Three months after a mass vaccination campaign (coverage: 100%) against measles a random seroepidemiological survey was carried out in students aged 1 to 19 years old in the Municipality of Niterói, State of Rio de Janeiro. Blood samples were tested for measles antibodies by enzyme immunosorbent assay (EIA) and negative cases were tested again using hemagglutination inhibition (HI) and plaque reduction neutralization (PRN). Of the 798 samples tested by EIA, 718 (90.2%) were positive for measles antibodies. PRN test was more sensitive than EIA and HI in detecting measles specific antibodies. The total antibody prevalence increased from 90.2% to 93.2% when HI was employed in EIA negative specimens and to 98.9% when PRN was used. After the mass vaccination campaign a marked decrease in measles incidence was observed in the municipality studied, showing the effectiveness of the strategy used for measles control in developing countries.Três meses após a campanha de vacinação em massa (cobertura: 100%, faixa etária: 9 meses a 14 anos) contra o sarampo, um inquérito soroepidemiológico foi realizado cm estudantes de um a 19 anos de idade no município de Niterói, estado do Rio de Janeiro. Amostras sangüíneas foram testadas para detecção de anticorpos específicos contra o sarampo por ensaio imunoenzimático (EIE), e os casos negativos testados outra vez utilizando-se a reação de inibição da hemaglutinação (IH) e a neutralização por redução de placas (NP). Das 798 amostras testadas por EIE, 718 (90,2%) foram positivas. A NP foi mais sensível que o EIE e a IH na detecção de anticorpos específicos. A soroprevalência de anticorpos aumentou de 90,2% para 93,2% quando a IH foi empregada em amostras EIE negativas e para 98,9% quando a NP foi utilizada. Após a campanha de vacinação em massa, verificou-se uma diminuição acentuada na incidência do sarampo no município estudado, demonstrando a efetividade da estratégia utilizada para o controle da doença em países em desenvolvimento