SEROPREVALENCE OF ANTI-RUBELLA AND ANTI-MEASLES IgG ANTIBODIES IN PREGNANT WOMEN IN SHIRAZ, SOUTHERN IRAN: OUTCOMES OF A NATIONWIDE MEASLES-RUBELLA MASS VACCINATION CAMPAIGN

Monday, 25th of August 2014

[source]PLoS One[|source]

The World Health Organization (WHO) recommends that countries undertaking measles elimination should use the opportunity to eliminate rubella as well through the use of measles and rubella containing vaccines in childhood immunization programs and campaigns. According to the Expanded Immunization Program in Iran, all 12- and 18-month-old infants are immunized with MMR vaccine, but in response to the increased numbers of cases in older age groups during 1996–2002, a nationwide MR vaccination campaign was conducted in December 2003, and 33.5 million persons (99%) aged 5 to 25 years were vaccinated.

Nearly one decade later, the authors conducted a cross-sectional sero-prevalence study to estimate the number of pregnant women at risk of developing CRS or measles complications. The report documents only 81.7% of the studied women had protective levels of measles IgG. Detailed report and recommendations on screening for measles and rubella in pregnancy are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3561451/

 

ABSTRACT

OBJECTIVE: Nonimmune pregnant women are at risk of developing congenital rubella syndrome and measles complications. We aimed to identify pregnant women susceptible to rubella or measles in order to determine the need for immunity screening and supplemental immunization in women of childbearing age.

METHOD: This seroprevalence survey was conducted by convenience sampling in obstetric hospitals affiliated with Shiraz University of Medical Sciences (southern Iran). Serum IgG levels were measured by ELISA.

RESULT: Mean age of the 175 pregnant women was 27.3±5.3 (range 16 to 42) years. The geometric mean concentration of anti-rubella IgG was 14.9 IU/mL (CI 95%,14.1–15.5), and that of anti-measles IgG was 13.8 IU/mL (CI 95%, 13–14.5). One hundred sixty-eight women (96%) had a protective serologic level (>11 IU/mL) of IgG against rubella, and 143 (81.7%) had a protective level against measles. Except for a significant inverse correlation that was showed by univariate analysis between anti-rubella IgG and the womens age (P=0.01), immunity did not correlate with demographic or obstetric characteristics or medical history. There was no significant correlation between anti-rubella and anti-measles IgG levels (P=0.25).

CONCLUSION: Nearly a decade after Iran implemented a nationwide measles-rubella vaccination campaign for the population aged 5–25 years, most pregnant women up to 34 years of age had humoral immunity against rubella. We recommend rubella immunity screening or catch-up immunization for women older than 35 years who wish to become pregnant, and measles immunity screening and appropriate vaccination for all women of childbearing age.