1/5. Persistent fetal rubella vaccine virus infection following inadvertent vaccination during early pregnancy.Inadvertent immunisation of seronegative women with RA27/3 rubella virus live-attenuated vaccine several weeks before and after conception is described. Whereas in 5 cases the vaccine virus was not transmitted vertically, in 1 case vaccination led to the development of persistent fetal infection with prolonged virus shedding for more than 8 months. sequence analysis carried out on isolates from amniotic fluid, from cord blood leukocytes as well as from infantile urine confirmed an infection by the vaccine strain. At birth, the newborn infant exhibited none of the symptoms compatible with the congenital rubella syndrome and signs indicative for development of late onset disease are not apparent. This observation constitutes the first unequivocal documented case of rubella vaccine virus related to persistent fetal infection.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
2/5. Detection of rubella-specific IgM in subclinical rubella reinfection in pregnancy.Seven cases of asymptomatic rubella reinfection in early pregnancy are described. In each, there was a history of exposure to a rubelliform illness and low levels of rubella-specific IgM subsequently appeared in the serum. Four of the women had been immunised, after having been shown to be susceptible to rubella, one had been immunised at school without previous antibody screening, and two were uncertain about immunisation. One pregnancy was terminated and rubella virus was not isolated from the products of conception. Six pregnancies went to term and the infants showed no evidence of intrauterine infection. In a further case it was impossible to discriminate between reinfection and primary infection, and termination of pregnancy was offered.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
3/5. First trimester prenatal diagnosis of congenital rubella: a laboratory investigation.Acute primary maternal infection with rubella virus during pregnancy often, but not invariably, leads to the congenital rubella syndrome. Diagnosis by detection of virus specific IgM in the mother is not always possible, and in those cases in which IgM is detected the fetus has not necessarily also been infected. A method for direct, prenatal detection of fetal infection would allow more accurate early diagnosis of congenital rubella syndrome. In this study a case of suspected preconception rubella infection that was not referred until 14 weeks after the appearance of a rash was studied to determine whether a retrospective serological diagnosis of primary rubella could be made, and whether direct evidence of fetal infection could be obtained from a chorionic villus biopsy specimen by detecting virus specific antigens or ribonucleic acid (rna) sequences. Monoclonal antibodies and a cloned complementary deoxyribonucleic acid probe were used successfully to detect antigens to rubella virus antigens and rna sequences in the chorionic villus biopsy specimen, which was taken at 15 weeks' gestation. This method should serve as a new approach to the diagnosis of congenital rubella syndrome in utero.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |
4/5. Congenital rubella affecting an infant whose mother had rubella antibodies before conception.A woman who had had high titres of rubella antibodies some months before she became pregnant gave birth to an infant in whom congenital rubella was confirmed at 4 months. Rubella haemagglutination inhibition tests, complement fixation tests, and immunofluorescence tests with anti-human IgG were carried out on sera from the mother. Rubella antibody titres in sera obtained in March 1971, seven and a half months before conception, were equivalent to 400 units, which is usually taken as indicating good immunity. rubella virus was isolated from the baby's nose and throat in July 1973 but was not isolated from a cervical swab taken from the mother in December 1973; tests of her immunological competence did not show any definite abnormality. The presence of high levels of rubella haemagglutination inhibition antibodies does not invariably confer immunity or exclude the possibility of congenital rubella in a subsequent pregnancy.- - - - - - - - - - ranking = 5keywords = conception (Clic here for more details about this article) |
5/5. Congenital rubella syndrome despite repeated vaccination of the mother: a coincidence of vaccine failure with failure to vaccinate.Congenital rubella syndrome occurred in a boy born to a mother who had been properly vaccinated three times before conception, but developed only low titers of rubella antibody. The non-vaccinated father most likely infected the mother on a home visit during the third to fifth weeks of gestation. He served in the army and fell ill during an outbreak of a rubella-like disease in his military unit. The mother subsequently developed a slight rash, but rubella IgM antibodies were lacking and rubella infection was not suspected. This incidence demonstrates the necessity of vaccinating all children, including boys and young men, in order to reduce the number of infections and prevent further cases of congenital rubella syndrome.- - - - - - - - - - ranking = 1keywords = conception (Clic here for more details about this article) |