Artigo
Identification of serologic markers for school-aged children with congenital rubella syndrome
Registro en:
The Journal of Infectious Diseases, v. 31, n. 2014, p. 1, 2014.
0022-1899
10.1093/infdis/jiu604
5090283757750819
5090283757750819
5090283757750819
Autor
Hyde, Terri B
Sato, Helena Keico
Hao, Li Juan
Flannery, Brendan
Zheng, Qi
Wannemuehler, Kathleen
Ciccone, Flavia Helena
Weckx, Lily Yin
Sáfadi, Marco Aurelio
Moraes, Eliane de Oliveira
Pinhata, Marisa Mussi
Olbrich Neto, Jaime [UNESP]
Bevilacqua, Maria Cecilia
Tabith Junior, Alfredo
Monteiro, Tatiana Alves
Figueiredo, Cristina Adelaide
Andrus, Jon K.
Reef, Susan E.
Toscano, Cristiana M.
Castillo-Solorzano, Carlos
Icenogle, Joseph P.
Resumen
Background: Congenital rubella syndrome (CRS) case identification is challenging in older children since laboratory markers of congenital rubella 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 rubella virus with their mothers’ or a group of similar-aged, non-CRS children. Demographic data and sera were collected. Sera were tested for anti-rubella immunoglobulin G (IgG), IgG avidity, and IgG response to the three viral structural proteins (E1, E2, and C) reflected by immunoblot fluorescent signals. Results: We enrolled 32 children with CRS, 31 mothers, and 62 non-CRS children. Immunoblot signal strength to C and C signal/rubella-specific IgG ratio concentrations, were higher (p<0.029) and, E1 signal/rubella-specific IgG ratio concentrations were lower in CRS children (p=0.001) than their mothers. Compared with non-CRS children, CRS children had more rubella-specific IgG (p<0.001), C signal (p<0.001) and E2 signal (p=<0.001). Two classification rules for CRS children versus non-CRS children gave 100% specificity with greater than 65% sensitivity Conclusions: This study was the first to establish classification rules for identifying CRS in schoolaged children using laboratory biomarkers. These biomarkers should allow improved burden of disease estimates and monitoring of CRS control programs. United States Centers for Disease Control and Prevention (CDC), USA São Paulo State Health Department, São Paulo, Brazil Pan American Health Organization (PAHO), Washington, DC, USA Children’s Institute, University Hospital, University of São Paulo (USP), São Paulo, Brazil Hospital São Paulo, Federal University de São Paulo (UNIFESP), São Paulo, Brazil School of Medical Sciences of Santa Casa (FCMSC), São Paulo, Brazil School of Medical Sciences, University of São Paulo, Campinas, Brazil University Hospital, University of São Paulo, Ribeirão Preto (USP/RP), Ribeirão Preto, Brazil Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Pediatria, Faculdade de Medicina de Botucatu, Botucatu, Distrito de Rubião Júnior, CEP 18618-970, SP, Brasil Audiology Research Center, Hospital for Rehabilitation of Cranofacial Abnormalities, University of São Paulo (USP), Bauru, Brazil Division of Education and Rehabilitation for Communication Disturbances (DERDIC), Catholic university of São Paulo (PUCSP), São Paulo, Brazil Division of Otorhinolaryngology, University of São Paulo Medical School (FM-USP) Adolfo Lutz Institute, São Paulo, Brazil Universidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Pediatria, Faculdade de Medicina de Botucatu, Botucatu, Distrito de Rubião Júnior, CEP 18618-970, SP, Brasil