Serologic survey of rubella in the pre-vaccine era in child-care centers, schools and maternity units of Fortaleza

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Abstract
OBJECTIVES: To identify rubella prevalence in different ages and population groups and rubella susceptibility of pregnant and postpartum women according to age, number of children and spontaneous abortion. METHODS: Cross-sectional study of sero-survey type. Children and students were selected in day-care centers and schools distributed by health districts of Fortaleza. Pregnant and postpartum healthy women were recruited in two large maternity units and three antenatal clinics; individuals previously vaccinated and presenting chronic or acute diseases where excluded. Written consent was obtained from participants or their caretakers. Anti-rubella IgG qualitative detection was performed with an Elisa-sandwich assay. RESULTS: Mean age-specific sero-prevalence rates of 999 samples were: 2 to 5 years= 59% (136/231); 6 to 9 years= 47% (95/204); 10 to 19 years= 56% (243/432) and 20 to 39 years= 80% (106/132). The mean age of 187 pregnant and postpartum women was 23 years (10-39) with a sero-prevalence of 76% (142/187), where 62% sero-positives aged 15 to 19 and 83% aged 26 to 39 years. A higher sero-prevalence was related to womeńs age (p<0.001), history of spontaneous abortion (p= 0.03), and two or more children (p=0.01). CONCLUSIONS: The high sero-prevalence of rubella in preschool age children reflects the intense viral transmission in child-care centers. The high susceptibility in adolescents (45%), among whom pregnancy is common, emphasizes the need to introduce rubella vaccine early and keep high immunization coverages in youngsters in order to eradicate congenital rubella syndrome. Also, postpartum routine immunization against rubella in this age group is of particular benefit.

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