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Pre-admission antibiotics for suspected cases of meningococcal disease. No adverse effects of treatment were reported. Estimated treatment costs were similar. No data were available on disease burden due to sequelae. We found no reliable evidence to support the use pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Moderate-quality evidence from one RCT indicated that single intramuscular injections of ceftriaxone and long-acting chloramphenicol were equally effective, safe, and economical in reducing serious outcomes.
The choice between these antibiotics should be based on affordability, availability, and patterns of antibiotic resistance. Further RCTs comparing different pre-admission antibiotics, accompanied by intensive supportive measures, are ethically justified in people with less severe illness, and are needed to provide reliable evidence in different clinical settings. Congenital rubella syndrome: a matter of concern. Full Text Available Congenital rubella syndrome CRS, an important cause of severe birth defects, remains a public health problem in a significant number of countries.
Therefore, global health experts encourage use of rubella vaccination, with the primary aim of preventing CRS. While large-scale rubella vaccination during the last decade has drastically reduced or eliminated both the virus and CRS in Europe and the Americas, many countries in Africa, South-East Asia, the Eastern Mediterranean, and the Western Pacific have not yet incorporated any type of rubella -containing vaccine into their immunization schedule. As a result, through travel and migration, rubella has been imported into countries that had successfully eliminated the virus, leading to outbreaks and the reestablishment of endemic transmission.
The objective of this study was to identify the key factors required for CRS elimination prevalence reduction, vaccination strategies, and surveillance methods by reviewing publications in PubMed on rubella and CRS systematic reviews, country experiences, and position papers from the World Health Organization WHO and other intergovernmental organizations.
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In addition to mass rubella immunization campaigns and routine childhood vaccination programs, the following measures should be taken to help fight rubella and CRS: 1. Rubella virus usually causes a mild fever and rash in children and adults. However, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of congenital malformations known as congenital rubella syndrome CRS. In , the World Health Organization WHO updated guidance on the preferred strategy for introduction of rubella -containing vaccine RCV into national routine immunization schedules, including an initial vaccination campaign usually targeting children aged 9 months years.
This report updates a previous report and summarizes global progress toward rubella and CRS control and elimination during To achieve the Global Vaccine Action Plan rubella and CRS elimination goals, RCV introduction needs to continue as country criteria indicating readiness are met, and rubella and CRS surveillance need to be strengthened to ensure that progress toward elimination can be measured.
The epidemiology of rubella in the Republic of Ireland. The trend in notified cases of rubella in the Republic of Ireland from to has been downward, with a mean interval of four years between peak periods. One hundred and six cases of congenital rubella were recorded between and , 66 being reported by paediatricians. The fact that cases of congenital rubella still occur highlights the need for a continued and aggressive immunisation policy, up-to-date and cohort-based data on vaccine uptake, and the introduction of a congenital rubella register.
Health economics of rubella : a systematic review to assess the value of rubella vaccination. Most cases of rubella and congenital rubella syndrome CRS occur in low- and middle-income countries. The World Health Organization WHO has recently recommended that countries accelerate the uptake of rubella vaccination and the GAVI Alliance is now supporting large scale measles- rubella vaccination campaigns.
We performed a review of health economic evaluations of rubella and CRS to identify gaps in the evidence base and suggest possible areas of future research to support the planned global expansion of rubella vaccination and efforts towards potential rubella elimination and eradication. We performed a systematic search of on-line databases and identified articles published between and on costs of rubella and CRS treatment and the costs, cost-effectiveness or cost-benefit of rubella vaccination.
We reviewed the studies and categorized them by the income level of the countries in which they were performed, study design, and research question answered.
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We analyzed their methodology, data sources, and other details. We used these data to identify gaps in the evidence and to suggest possible future areas of scientific study.
We identified 27 studies: 11 cost analyses, 11 cost-benefit analyses, 4 cost-effectiveness analyses, and 1 cost-utility analysis. Of these, 20 studies were conducted in high-income countries, 5 in upper-middle income countries and two in lower-middle income countries. We did not find any studies conducted in low-income countries. Rubella vaccination programs, including the vaccination of health workers, children, and women had favorable cost-effectiveness, cost-utility, or cost-benefit ratios in high- and middle-income countries.
Treatment of CRS is costly and rubella vaccination programs are highly cost-effective. However, in order for research to support the. Does rubella cause autism: a reappraisal? Full Text Available In the s, Stella Chess found a high prevalence of autism in children with congenital rubella syndrome CRS, times that of the general population at the time. Many researchers quote this fact to add proof to the current theory that maternal infection with immune system activation in pregnancy leads to autism in the offspring.
CRS cases are no longer typically seen, yet autistic children often share findings of CRS including deafness, congenital heart defects and to a lesser extent visual changes. Autistic children commonly have hyperactivity and spasticity, as do CRS children.
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Both autistic and CRS individuals may develop type 1 diabetes as young adults. Neuropathology of CRS infants may reveal cerebral vasculitis with narrowed lumens and cerebral necrosis. Neuroradiologic findings of children with CRS show calcifications, periventricular leukomalacia, and dilated perivascular spaces. Neuroradiology of autism has also demonstrated hyperintensities, leukomalacia and prominent perivascular spaces.
PET studies of autistic individuals exhibit decreased perfusion to areas of the brain similarly affected by rubella. In both autism and CRS, certain changes in the brain have implicated the immune system.
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Several children with autism lack antibodies to rubella , as do children with CRS. These numerous similarities increase the probability of an association between rubella virus and autism. Rubella and autism cross many ethnicities in many countries. Susceptibility continues as vaccines are not given worldwide and are not fully protective. Rubella might still cause autism, even in vaccinated populations. In the s, Stella Chess found a high prevalence of autism in children with congenital rubella syndrome CRS , times that of the general population at the time. This rubella and autism association is presented with the notion that rubella has been eliminated in today's world.
CRS cases are no longer typically seen; yet, autistic children often share findings of CRS including deafness, congenital heart defects, and to a lesser extent visual changes. Neuroradiological findings of children with CRS show calcifications, periventricular leukomalacia, and dilated perivascular spaces.
Neuroradiology of autism has also demonstrated hyperintensities, leukomalacia, and prominent perivascular spaces. Congenital rubella syndrome in Haiti Short communication. A suspected case of Addison's disease in cattle. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism Addison's disease. Although Addison's disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.
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Lack of association between measles-mumps- rubella vaccination and autism in children: a case -control study. The first objective of the study was to determine whether there is a relationship between the measles-mumps- rubella MMR vaccination and autism in children. The second objective was to examine whether the risk of autism differs between use of MMR and the single measles vaccine.
Case -control study. The 96 cases with childhood or atypical autism, aged 2 to 15, were included into the study group. Controls consisted of children individually matched to cases by year of birth, sex, and general practitioners. Data on autism diagnosis and vaccination history were from physicians. Data on the other probable autism risk factors were collected from mothers. Logistic conditional regression was used to assess the risk of autism resulting from vaccination.
Assessment was made for children vaccinated 1 Before diagnosis of autism, and 2 Before first symptoms of autism onset. Odds ratios were adjusted to mother's age, medication during pregnancy, gestation time, perinatal injury and Apgar score. For children vaccinated before diagnosis, autism risk was lower in children vaccinated with MMR than in the nonvaccinated OR: 0. The risk for vaccinated versus nonvaccinated independent of vaccine type was 0.
The risk connected with being vaccinated before onset of first symptoms was significantly lower only for MMR versus single vaccine OR: 0. The study provides evidence against the association of autism with either MMR or a single measles vaccine. Laboratory-confirmed Congenital Rubella Syndrome at the Zambia- Case Reports. Rubella Immunoglobulin M IgM results were positive. The third case , a girl, was seen at twelve weeks and brought in for slow growth rate.
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Objective: A rapid diagnosis method was developed to detect Rubella virus infection in radiation workers. Results: Conclusion: Detection of Rubella virus in exposed radiation workers was imperative, and vaccine against Rubella virus was also needed to eliminate the infection risk. Congenital rubella syndrome and autism spectrum disorder prevented by rubella vaccination - United States, The objective of this study was to estimate the numbers of CRS and ASD cases prevented by rubella vaccination in the United States from through Methods Prevention estimates were calculated through simple mathematical modeling, with values of model parameters determined from published literature.
Results Based on our estimates, 16, CRS cases range: , were prevented by rubella vaccination from through in the United States. An estimated ASD cases were prevented by rubella vaccination in the United States during this time period. These findings provide additional incentive to maintain high measles-mumps- rubella MMR vaccination coverage. Early diagnosis of dengue virus infection in clinically suspected cases. Objective: Comparison of real time reverse transcriptase polymerase chain reaction RTPCR and immunoglobulin M IgM capture enzyme linked immunosorbent assay ELISA for diagnosis of dengue virus infection in first week of illness in clinically suspected patients of dengue fever.
Study Design: Cross sectional study. Material and Methods: A cross sectional study including 68 clinically suspected patients of dengue fever according to the World Health Organization WHO criteria.