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The serologic diagnosis consists of demonstrating the presence of rubella-specific immunoglobulin M (IgM) antibody in a single serum sample or observation of a significant (>4-fold) rise in rubella-specific immunoglobulin G (IgG) antibody titer between the acute and convalescent serum specimens drawn 2-3 weeks apart.
False-positive rubella IgM test results have been reported in persons with other viral infections (eg, acute Epstein-Barr virus [EBV], infectious mononucleosis, cytomegalovirus [CMV] infection, parvovirus B19 infection) and in the presence of r heumatoid factor (RF).
To demonstrate a 4-fold rise in rubella-specific IgG antibody, a serum sample should be obtained as soon as possible during the acute phase of infection and tested for rubella-specific IgG antibody. An aliquot of this serum should be frozen and stored for repeat testing later. Then, a second serum specimen is collected at 2-3 weeks and tested in the same laboratory at the same time with the first serum sample. The levels of rubella-specific IgG are compared between the first and the second sample to show a significant rise in antibody titers.
Rubella reinfection
Reinfection is a rubella infection occurring in an individual known to be immune to rubella either through naturally acquired disease or as a result of immunization against rubella infection. Rubella reinfection is estimated to occur in 5-10% of persons previously immune to rubella. It is usually subclinical but occasionally may be clinically apparent.
Maternal reinfection is uncommon but can occur, and, as noted above, congenital rubella syndrome occurring after maternal reinfection has been rarely been reported in the literature, especially after a clinically apparent rubella reinfection. Thus, all pregnant women should avoid rubella exposure.
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[Rubella in pregnancy. Management and prevention]
Presse Med. 1999; 28(38):2117-22 (ISSN: 0755-4982)
Marret H ; Golfier F ; Di Maio M ; Champion F ; Attia-Sobol J ; Raudrant D
Département de Gynécologie, Obstétrique et Médecine foetale de l'Hôtel-Dieu, Lyon.
DECLINING INCIDENCE: Between 1982 and 1994, the incidence of rubella infections during pregnancy in France declined form 45 to 9 cases per 100,000 births. The incidence of congenital rubella declined from 5 to 0.85 per 100,000 births. These results are the fruit of systematic vaccination of 1-year-old children in France. Eradication of congenital rubella has been achieved in Sweden and requires further efforts to be obtained in our country. SEROLOGY: Physicians must systematically check rubella serologies in all women desiring pregnancy and/or of reproductive age even if they have been vaccinated.
Врачи должны систематически проверить серологию краснухи у всех женщин, желающих беременности и/или репродуктивного возраста, даже если они были привиты.
Rubella serology must be checked in all pregnant women even if they were seropositive during a prior pregnancy. IN CASE OF EXPOSURE OR ERUPTION DURING PREGNANCY: Serology must be obtained as early as possible in case of suspected rubella infection during pregnancy with a second serology 3 weeks later. The IgM titre should be obtained in case of suspected exposure with significant rise in IgG in successive serologies, if specific IgG titre is elevated after an eruption, if the first serum sample was taken late after suspected exposure, and finally if a systematic serology early in pregnancy is positive after a previously negative serology. ANTENATAL DIAGNOSIS: PCR on amniotic fluid or fetal blood is indicated if a seroversion occurs before 18 weeks gestation. Therapeutic termination of pregnancy should be proposed if fetal infection is certain. After 18 weeks, there is nearly no risk for the fetus: an antenatal diagnostic sample is not required and ultrasound surveillance is sufficient.
PreMedline Identifier: 10613203
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