Rubella immunity in native Turkish and Syrian immigrant pregnant women between 2010-2018

Objectives: The study has aimed to investigate the rubella immunity in native-Turkish and Syrian-immigrant pregnant women in Turkey. Methods: Between September 2010 and December 2018, the hospital records of pregnant patients were evaluated retrospectively. For each year, for the number of patients who were screened for rubella IgG and/or IgM antibodies, IgG avidity (if any), and PCR tests (if any) were investigated, and subjects were categorized by nationality. Results: During the study period, a total of 80,302 pregnant were tested with at least one of the rubella IgM or IgG antibodies. Of these, 22,962 pregnant women were screened for both IgG and IgM, 24,684 were screened for IgG, and 78,580 pregnant women were screened for IgM rubella antibodies. The seropositivity rate of IgG rubella antibodies in native and Syrian pregnant groups was 93.8% and 95.9%, respectively. In both groups, the IgM rubella antibodies were found as 0.5%. IgG avidity was investigated in 252 patients, whose test results were positive for IgM and IgG; and a low IgG avidity was detected in 5 native patients, while none was detected in the Syrian group. Conclusions: In the Syrian immigrant group, the susceptibility to Rubella is low, and it does not differ from the native Turkish population.

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  • 1. Lambert N, Strebel P, Icenogle J, Poland GA. Rubella. Lancet 2015;385:2297-307.
  • 2. Al-rubaii B, Aboud M, Hamza W. Evaluation of Anti-rubella antibodies among childbearing age women in Babylon Governorate. Med J Babylon 2010;7:233-49.
  • 3. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM. Measles, mumps, and rubella. Clin Obstet Gynecol 2012;55:550-9.
  • 4. Lane S, MacDonald NE, Marti M, Dumolard L. Vaccine hesitancy around the globe: Analysis of three years of WHO/UNICEF Joint Reporting Form data-2015-2017. Vaccine 2018;36:3861-7.
  • 5. Çalışkan D, Piyal B, Akdur R, Ocaktan ME, Yozgatligil C. An analysis of the incidence of measles in Turkey since 1960. Turk J Med Sci 2016;46:1101-6.
  • 6. United Nations High Commissioner for Refugees. Syria Refugee Crisis Explained 2020. [Available from: https://www.unrefugees.org/news/syria-refugee-crisis-explained/.
  • 7. Wandinger K-P, Saschenbrecker S, Steinhagen K, Scheper T, Meyer W, Bartelt U, et al. Diagnosis of recent primary rubella virus infections: significance of glycoprotein-based IgM serology, IgG avidity and immunoblot analysis. J Virol Methods 2011;174:85-93.
  • 8. Ho-Terry L, Terry GM, Londesborough P. Diagnosis of foetal rubella virus infection by polymerase chain reaction. J Gen Virol 1990;71:1607-11.
  • 9. Tang JW, Aarons E, Hesketh LM, Strobel S, Schalasta G, Jauniaux E, et al. Prenatal diagnosis of congenital rubella infection in the second trimester of pregnancy. Prenat Diagn 2003;23:509-12.
  • 10. Abernathy E, Cabezas C, Sun H, Zheng Q, Chen M-h, Castillo-Solorzano C, et al. Confirmation of rubella within 4 days of rash onset: comparison of rubella virus RNA detection in oral fluid with immunoglobulin M detection in serum or oral fluid. J Clin Microbiol 2009;47:182-8.
  • 11. Bellini WJ, Icenogle JP. Measles and rubella viruses. Manual of Clinical Microbiology, 10th Edition: American Society of Microbiology; 2011: p.1372-87.
  • 12. Terkawi AS, Bakri B, Alsadek AS, Al-Hasan AH, Alrahhal MS, Alsaleh FM, et al. Child and adolescent health in northwestern Syria: findings from Healthy-Syria 2017 study. Avicenna J Med 2019;9:61-74.
  • 13. Ekmekci PE. Syrian refugees, health and migration legislation in Turkey. J Immigr Minor Health 2017;19:1434-41.
  • 14. Adam O, Musa A, Kamer A, Sausy A, Tisserand E, Hübschen JM. Seroprevalence of measles, mumps, and rubella and genetic characterization of mumps virus in Khartoum, Sudan. Int J Infect Dis 2020;91:87-93.
  • 15. Tushabe P, Bwogi J, Abernathy E, Birungi M, Eliku JP, Seguya R, et al. Descriptive epidemiology of rubella disease and associated virus strains in Uganda. J Med Virol 2020;92:279-87.
  • 16. Çetinkaya RA, Yenilmez E. The seroprevalence of Rubella in pregnant women in Turkey: a meta-analysis research of 90988 Rubella IgM, 84398 Rubella IgG, and 522 avidity results. Turk J Obstet Gynecol 2019;16:63-71.
  • 17. Başkesen T, Ecemiş T, Şanlıdağ T. Evaluation of Rubella immunity in pregnants. Med J Kocatepe 2010;11:19-22.
  • 18. Mehmet O, Doğan Y, Bademkıran MH, Akgöl S, Kahveci B, Peker N, et al. [Toxoplasma, rubella and cytomegalovirus seroprevalence in pregnant women in Diyarbakir]. Dicle Med J 2019;46:189-94. [Article in Turkish]
  • 19. Çoşkun B, Gülümser Ç, Çoşkun B, Artuk C, Karaşahin KE. Impact of Syrian refugees on congenital TORCH infections screening in Turkey. J Obstet Gynaecol Res 2020;46:1017-24.
  • 20. Orenstein W, Hinman A, Nkowane B, Olive J, Reingold A. Measles and rubella global strategic plan 2012-2020 midterm review. Vaccine 2018;36:A1-A34.
  • 21. Reef SE, Plotkin S, Cordero JF, Katz M, Cooper L, Schwartz B, et al. Preparing for elimination of congenital rubella syndrome (CRS): summary of a workshop on CRS elimination in the United States. Clin Infect Dis 2000;31:85-95.
  • 22. American College of Obstetricians and Gynecologists. Routine Tests During Pregnancy: American College of Obstetricians and Gynecologists; 2019. [Available from: https://www.acog.org/patient-resources/faqs/pregnancy/routine-tests-during-pregnancy
  • 23. Matthews LA, Lawrance LM, Gray D, Gray S. An audit of rubella IgG antibody status in antenatal women in a NHS Trust over 5 years (2005-2009). Epidemiol Infect 2011;139:1720-6.
  • 24. Grant GB, Desai S, Dumolard L, Kretsinger K, Reef SE. Progress toward rubella and congenital rubella syndrome control and elimination - Worldwide, 2000-2018. MMWR Morb Mortal Wkly Rep 2019;68:855-9.
  • 25. Cooper LZ. The history and medical consequences of rubella. Clin Infect Dis. 1985;7(Suppl 1):S2-S10.
  • 26. Reef SE, Strebel P, Dabbagh A, Gacic-Dobo M, Cochi S. Progress toward control of rubella and prevention of congenital rubella syndrome—worldwide, 2009. J Infect Dis 2011;204(suppl 1):S24-S7.
  • 27. Plan GVA. Decade of vaccine collaboration. Vaccine 2013;31(Suppl 2):B5-31.
  • 28. Rubella Vaccination Centres for Disease Control and Prevention. [05 May 2020]. Available from: https://www.cdc.gov/rubella/vaccination.html
  • 29. WHO vaccine-preventable diseases: monitoring system. 2020 global summary.[05 May 2020] [Available from: ttps://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=SYR.
  • 30. Morgan-Capner P, Miller E, Vurdien JE, Ramsay ME. Outcome of pregnancy after maternal reinfection with rubella. CDR (London, Engl Rev) 1991;1:R57-9.