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HOSPITALS & HEALTH CENTERS DIRECTORY
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Patient Safety - Medical Devices Registration System
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Rubella
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Rubella surveillance
Background |
| Rubella is a common cause of mild febrile viral disease in childhood with rash and fever. Its public health importance relates to the teratogenic effects on primary rubella infection in pregnant women. Congenital rubella syndrome (CRS) is an under-recognized public health problem in many developing countries. In Lebanon, rubella was included in the Expanded Program for Immunization since 1996. |
Objectives |
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In order to control rubella disease and prevent CRS, Rubella-Containing Vaccines (RCV) was introduced in the national immunization schedule since 1987.
Rubella surveillance aims to identify high risk areas or population, to understand the changing epidemiology of the disease, and to predict the occurrence of outbreaks. As rubella surveillance adopts a syndromic approach, rubella was integrated in the measles surveillance. |
Case definition |
- Suspect cases of Rubella:
- - Suspected case of rubella is any maculo-papular rash with fever.
- - Also suspected case of rubella is any case diagnosed by the physician as rubella.
- Confirmed cases of Rubella:Confirmed case of rubella is the case with positive IgM rubella serology.
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Rubella reporting |
Rubella cases are reported to MOPH through 3 reporting channels:
- - Routine passive reporting system, where practitioner reports to MOPH via the peripheral or central levels
- - Hospital weekly zero-reporting, where the designated hospital focal person reports to MOPH on weekly basis on the presence or absence of rubella cases
- - Hospital active surveillance, where MOPH officers search, on weekly basis, in selected major hospitals on rubella cases
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Case-based rubella surveillance |
Rubella investigation aims to collect data and specimens from cases, in order to confirm cases and explain the occurrence of the case by evaluating the vaccination status.
Data is collected through a specific form for measles and rubella investigation. The practitioner who reported the case is asked to fill the specific form and to send it to the MOPH. Data collected is related to demographic characteristics, clinical findings, complications issues and vaccination status.
Clinical specimen (blood, dried blood or oral fluid) is collected during the 28 days following rash onset. For blood specimen, at least 5 cc of blood is collected in sterile dry tube. Blood is centrifuged at 1000xg for 10 minutes. Serum is collected in a sterile dry tube and preserved at 4-8 C. Secondly the serum specimen are collected by the MOPH and transmitted to the national reference laboratory at the Rafic Hariri Universit Hospital (RHUH).
At RHUH, specimen are tested first for Measles IgM. If Measles IgM serology is negative, specimens are tested for Rubella IgM. Results are communicated to the ESP, who has in charge to communicate them to the practitioner. |
Rubella classification |
For acquired rubella, the WHO-laboratory classification is used as follows:
- - Rubella laboratory-confirmed: a case that meets the clinical case definition and is laboratory confirmed (i.e. presence of rubella-specific IgM antibodies)
- - Rubella epidemiologically-confirmed: a case that meets the clinical case definition and is linked epidemiologically to a laboratory-confirmed case
- - Rubella clinically-confirmed: a case that meets the clinical case definition and for which no adequate blood specimen was taken.
- - Rubella-discarded: a suspected case that does not meet the clinical or laboratory definition.
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