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Khalil A, Sotiriadis A, Chaoui R, da Silva Costa F, D'Antonio F, Heath PT, Jones C, Malinger G, Odibo A, Prefumo F, Salomon LJ, Wood S, Ville Y. ISUOG Practice Guidelines: role of ultrasound in congenital infection. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:128-151. [PMID: 32400006 DOI: 10.1002/uog.21991] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - A Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - F da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - F D'Antonio
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
| | - P T Heath
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's University of London and St George's University Hospitals NHS Trust, London, UK
| | - C Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G Malinger
- Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Odibo
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - F Prefumo
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - L J Salomon
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
| | | | - Y Ville
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
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Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev 2019; 33:33/1/e00130-18. [PMID: 31826871 DOI: 10.1128/cmr.00130-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.
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Isaac BM, Zucker JR, Giancotti FR, Abernathy E, Icenogle J, Rakeman JL, Rosen JB. Rubella Surveillance and Diagnostic Testing among a Low-Prevalence Population, New York City, 2012-2013. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017; 24:e00102-17. [PMID: 28701468 PMCID: PMC5585696 DOI: 10.1128/cvi.00102-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/05/2017] [Indexed: 11/20/2022]
Abstract
The New York City Department of Health and Mental Hygiene (DOHMH) receives clinical and laboratory reports for rubella. Because rubella immunoglobulin M (IgM) assays may produce false-positive results and rubella infections may be asymptomatic, interpretation of positive IgM results can be challenging. Rubella reports received by DOHMH in 2012 to 2013 were reviewed. The rubella IgM testing purpose was determined through case investigation. Results of IgM testing by indirect enzyme-linked immunosorbent assay (ELISA) and capture enzyme immunoassay (EIA) were compared to determine positive predictive value (PPV) and specificity. DOHMH received 199 rubella reports; 2 were true cases. Of all reports, 77.9% were tested for rubella IgM erroneously, 19.6% were tested for diagnostic purposes, 2.0% had unknown test purpose, and 0.5% were not tested. PPV of indirect ELISA was 6% overall, 14% for diagnostic tests, and 0% for tests ordered erroneously. PPV of capture EIA was 29% overall, 50% for diagnostic tests, and 0% for tests ordered erroneously. Overall, specificity was 52% for indirect ELISA and 85% for capture EIA. Limiting rubella IgM testing to patients for whom rubella diagnosis is suspected and using a more specific IgM assay have the potential to reduce false-positive rubella IgM results.
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Affiliation(s)
- Beth M Isaac
- Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA
- Council of State and Territorial Epidemiologists/Centers for Disease Control and Prevention Applied Epidemiology Fellowship, Atlanta, Georgia, USA
| | - Jane R Zucker
- Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Francesca R Giancotti
- Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Emily Abernathy
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joseph Icenogle
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer L Rakeman
- Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Jennifer B Rosen
- Bureau of Immunization, New York City Department of Health and Mental Hygiene, Queens, New York, USA
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Bolotin S, Lim G, Dang V, Crowcroft N, Gubbay J, Mazzulli T, Schabas R. The utility of measles and rubella IgM serology in an elimination setting, Ontario, Canada, 2009-2014. PLoS One 2017; 12:e0181172. [PMID: 28850604 PMCID: PMC5574571 DOI: 10.1371/journal.pone.0181172] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 06/27/2017] [Indexed: 11/17/2022] Open
Abstract
In Canada, measles was eliminated in 1998 and rubella in 2000. Effective measles and rubella surveillance is vital in elimination settings, hinging on reliable laboratory methods. However, low-prevalence settings affect the predictive value of laboratory tests. We conducted an analysis to determine the performance of measles and rubella IgM testing in a jurisdiction where both infections are eliminated. 21,299 test results were extracted from the Public Health Ontario Laboratories database and 1,239 reports were extracted from the Ontario Integrated Public Health Information System (iPHIS) from 2008 and 2010 for measles and rubella, respectively, to 2014. Deterministic linkage resulted in 658 linked measles records (2009-2014) and 189 linked rubella records (2010-2014). Sixty-six iPHIS measles entries were classified as confirmed cases, of which 53 linked to laboratory data. Five iPHIS rubella entries were classified as confirmed, all linked to IgM results. The positive predictive value was 17.4% for measles and 3.6% for rubella. Sensitivity was 79.2% for measles and 100.0% for rubella. Specificity was 65.7% for measles and 25.8% for rubella. Our study confirms that a positive IgM alone does not confirm a measles case in elimination settings. This has important implications for countries that are working towards measles and rubella elimination.
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Affiliation(s)
- Shelly Bolotin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Lim
- Public Health Ontario, Toronto, Ontario, Canada
| | - Vica Dang
- Public Health Ontario, Toronto, Ontario, Canada
| | - Natasha Crowcroft
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Gubbay
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tony Mazzulli
- Public Health Ontario, Toronto, Ontario, Canada
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Richard Schabas
- Hastings Prince Edward Public Health, Belleville, Ontario, Canada
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Farra A, Pagonendji M, Manikariza A, Rawago D, Ouambita-Mabo R, Guifara G, Gouandjika-Vasilache I. Epidemiology of primary rubella infection in the Central African Republic: data from measles surveillance, 2007-2014. BMC Infect Dis 2016; 16:505. [PMID: 27659859 PMCID: PMC5034660 DOI: 10.1186/s12879-016-1842-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 09/17/2016] [Indexed: 11/18/2022] Open
Abstract
Background Although rubella is generally considered a benign childhood disease, infection of a pregnant woman can cause foetal congenital rubella syndrome, which results in embryo-foetal disease and malformations. The syndrome is still a public health problem in developing countries where the vaccine has not yet been introduced, such as the Central African Republic (CAR). The aim of the study reported here was to define the epidemiology of primary rubella infection, in order to determine its effect on morbidity rates in the country. Methods Data derived from epidemiological surveillance of measles and rubella were analysed retrospectively between 1 January 2007 and 31 December 2014. The database includes cases of suspected measles, according to the WHO clinical case definition. In this algorithm, samples that are negative or doubtful by ELISA for measles (presence of immunoglobulin M) are tested in another ELISA for detection of rubella-specific IgM. Descriptive analyses were conducted for socio-demographic characteristics, including age, sex and health region, for patients tested for rubella. Results Of the sera tested for rubella, 30.2 % (425/1409) were positive, 62.3 % (878/1409) were negative, and 7.5 % (106/1409) were doubtful. Among the 425 positive cases, 213 (50.1 %) were female and 212 (40.9 %) were male with a sex ratio of 1.03. The mean age was 8 years (range, 6–37 years). The highest prevalence (47.3 %; 116/425) was seen in 2007 and the lowest (8.9 %; 11/425) in 2012. Primary infections were always more frequent during the first 3 months of the year, with a peak at the same time, between January and February which is the hottest period of the year in the CAR. In both sexes, rubella IgM was rarely found before the age of 1 year (0.5 %; 2/425). The highest rate (43.5 %; 185/425) was observed at ages 5–9 years; however, at least 8 % (18/213) of girls aged 15 or more had primary infections. Conclusions Sentinel sites for surveillance of congenital rubella syndrome are urgently needed, and introduction of vaccination against rubella in the Expanded Programme of Immunization should be considered, to ensure immunization of girls of reproductive age.
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Affiliation(s)
- Alain Farra
- Enteric viruses and Measles Laboratory, Institut Pasteur de Bangui, Bangui, BP 923, Central African Republic.
| | - Marilou Pagonendji
- Enteric viruses and Measles Laboratory, Institut Pasteur de Bangui, Bangui, BP 923, Central African Republic
| | | | - Dieubéni Rawago
- Epidemiology Unit, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Rock Ouambita-Mabo
- Expanded Programme on Immunization, Ministry of Health, Bangui, Central African Republic
| | - Gilbert Guifara
- Epidemiological Surveillance Unit, World Health Organization, Bangui, Central African Republic
| | - Ionela Gouandjika-Vasilache
- Enteric viruses and Measles Laboratory, Institut Pasteur de Bangui, Bangui, BP 923, Central African Republic
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Vaidya SR, Raut CG, Jadhav SM. Laboratory confirmation of rubella infection in suspected measles cases. J Med Virol 2016; 88:1685-9. [DOI: 10.1002/jmv.24535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Sunil R. Vaidya
- World Health Organization Accredited National Reference Laboratory for Measles and Rubella National Institute of Virology (Indian Council of Medical Research); Pune Maharashtra India
| | - Chandrashekhar G. Raut
- World Health Organization accredited National Laboratory for Measles and Rubella National Institute of Virology Unit; Rajiv Gandhi Institute of Chest Diseases Premises; Bengaluru Karnataka India
| | - Santoshkumar M. Jadhav
- World Health Organization Accredited National Reference Laboratory for Measles and Rubella National Institute of Virology (Indian Council of Medical Research); Pune Maharashtra India
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