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J Infect Dis. 2015 Jul 1;212(1):57-66. doi: 10.1093/infdis/jiu604. Epub 2014 Oct 31.

Identification of Serologic Markers for School-Aged Children With Congenital Rubella Syndrome.

Author information

1
Centers for Disease Control and Prevention, Atlanta, Georgia.
2
São Paulo State Health Department.
3
Centers for Disease Control and Prevention, Atlanta, Georgia Pan American Health Organization, Washington, D. C.
4
Children's Institute, University Hospital, University of São Paulo (USP).
5
Hospital São Paulo, Federal University de São Paulo.
6
School of Medical Sciences of Santa Casa.
7
School of Medical Sciences, USP, Campinas.
8
University Hospital, USP, Ribeirão Preto.
9
University Hospital of Botucatu.
10
Audiology Research Center, Hospital for Rehabilitation of Cranofacial Abnormalities, USP, Bauru, Brazil.
11
Division of Education and Rehabilitation for Communication Disturbances, Catholic University of São Paulo.
12
Division of Otorhinolaryngology, USP Medical School.
13
Adolfo Lutz Institute, São Paulo.
14
Pan American Health Organization, Washington, D. C.

Abstract

BACKGROUND:

Congenital rubella syndrome (CRS) case identification is challenging in older children since laboratory markers of congenital rubella virus (RUBV) infection do not persist beyond age 12 months.

METHODS:

We enrolled children with CRS born between 1998 and 2003 and compared their immune responses to RUBV with those of their mothers and a group of similarly aged children without CRS. Demographic data and sera were collected. Sera were tested for anti-RUBV immunoglobulin G (IgG), IgG avidity, and IgG response to the 3 viral structural proteins (E1, E2, and C), reflected by immunoblot fluorescent signals.

RESULTS:

We enrolled 32 children with CRS, 31 mothers, and 62 children without CRS. The immunoblot signal strength to C and the ratio of the C signal to the RUBV-specific IgG concentration were higher (P < .029 for both) and the ratio of the E1 signal to the RUBV-specific IgG concentration lower (P = .001) in children with CRS, compared with their mothers. Compared with children without CRS, children with CRS had more RUBV-specific IgG (P < .001), a stronger C signal (P < .001), and a stronger E2 signal (P ≤ .001). Two classification rules for children with versus children without CRS gave 100% specificity with >65% sensitivity.

CONCLUSIONS:

This study was the first to establish classification rules for identifying CRS in school-aged children, using laboratory biomarkers. These biomarkers should allow improved burden of disease estimates and monitoring of CRS control programs.

KEYWORDS:

CRS; biomarkers; congenital rubella syndrome; immune response; rubella; serology

PMID:
25362195
PMCID:
PMC4654588
DOI:
10.1093/infdis/jiu604
[Indexed for MEDLINE]
Free PMC Article

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