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Abstract

Background

In Belgium, rubella serology is frequently requested in women of childbearing age, despite high vaccination coverage and a near-absence of congenital rubella cases. Different test kits are available and should be standardised by an international standard preparation.

Aim

To analyse and compare rubella serology practices in Belgian laboratories.

Methods

As part of the mandatory External Quality Assessment programme for rubella serology in Belgium, the national public health institute, Sciensano, sent a voluntary questionnaire concerning anti-rubella IgM/IgG analyses in women aged 15 to 45 years in 2017 to 130 laboratories.

Results

The questionnaire response rate was 83.8% (109/130). The majority of 169,494 IgG analyses were performed on Roche (55%), Abbott (17%) and Diasorin (13%) analysers. Not all laboratories used the proposed international cut-off of 10 IU/mL. Assumed median seroprevalence ranged from 76.3% with Liaison (Diasorin) to 96.3% with Modular (Roche). Despite very low rubella incidence in Belgium, 93 laboratories performed 85,957 IgM analyses, with 748 positive and 394 grey zone results. The National Reference Centre for Measles, Mumps and Rubella virus and the National Reference Centre for Congenital infections did not confirm any positive rubella cases in 2017.

Conclusion

This retrospective analysis shows that rubella serology results may differ considerably according to the assay used. It is therefore important to use the same test when comparing results or performing follow-up testing. The number of anti-rubella IgM analyses was very high. Incorrect use of IgM for screening women of childbearing age can lead to unwarranted anxiety and overuse of confirmation tests.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2021-05-20
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.20.2000074
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References

  1. Lee JY, Bowden DS. Rubella virus replication and links to teratogenicity. Clin Microbiol Rev. 2000;13(4):571-87.  https://doi.org/10.1128/CMR.13.4.571  PMID: 11023958 
  2. Barlinn R, Vainio K, Samdal HH, Nordbø SA, Nøkleby H, Dudman SG. Susceptibility to cytomegalovirus, parvovirus B19 and age-dependent differences in levels of rubella antibodies among pregnant women. J Med Virol. 2014;86(5):820-6.  https://doi.org/10.1002/jmv.23757  PMID: 24114849 
  3. Smits G, Mollema L, Hahné S, de Melker H, Tcherniaeva I, van der Klis F, et al. Seroprevalence of rubella antibodies in The Netherlands after 32 years of high vaccination coverage. Vaccine. 2014;32(16):1890-5.  https://doi.org/10.1016/j.vaccine.2014.01.066  PMID: 24513012 
  4. Mortlock S, Farthing S. Rubella antibody status of patients attending a south-west London antenatal clinic, 2007-2012. Br J Biomed Sci. 2014;71(3):111-4.  https://doi.org/10.1080/09674845.2014.11669975  PMID: 25265756 
  5. European Centre for Disease Prevention and Control (ECDC). Measles and rubella surveillance - 2017 report. Stockholm: ECDC; 2018. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Measles-and-Rubella-Surveillance-2017.pdf
  6. Sciensano. Rubella report 2018. Brussels: Sciensano. [Accessed: 15 Apr 2019]. Dutch. Available from: https://www.sciensano.be/en/biblio/epidemiologische-surveillance-van-rubella-rubellavirus-2018
  7. Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA. Rubella. Lancet. 2015;385(9984):2297-307.  https://doi.org/10.1016/S0140-6736(14)60539-0  PMID: 25576992 
  8. Federaal Kenniscentrum - Centre fédéral d'expertise (KCE). Performance of the Belgian health system – report 2019. Brussels: KCE. [Accessed 26 Jun 2020]. Available from: https://www.healthybelgium.be/metadata/hspa/p1_p2_p3.pdf
  9. Anderson RM, May RM. Immunisation and herd immunity. Lancet. 1990;335(8690):641-5.  https://doi.org/10.1016/0140-6736(90)90420-A  PMID: 1969023 
  10. Belgian Health Care Knowledge Centre (KCE). What are the recommended clinical assessment and screening tests during pregnancy? KCE Report 248. Brussels: KCE; 2015. Available from: https://kce.fgov.be/sites/default/files/atoms/files/KCE_248_assessments_and_test_during_pregnancy_Report_0.pdf
  11. Huzly D, Hanselmann I, Neumann-Haefelin D, Panning M. Performance of 14 rubella IgG immunoassays on samples with low positive or negative haemagglutination inhibition results. J Clin Virol. 2016;74:13-8.  https://doi.org/10.1016/j.jcv.2015.11.022  PMID: 26638144 
  12. National Committee for Clinical Laboratory Standards (NCCLS). Evaluation and Performance Criteria for Multiple Component Test Products Intended for the Detection and Quantitation of Rubella IgG antibody, NCCLS Document 12. I/LA6-T1992. Wayne, Pa: NCCLS. [Accessed 18 Jan 2020].
  13. Skendzel LP. Rubella immunity. Defining the level of protective antibody. Am J Clin Pathol. 1996;106(2):170-4.  https://doi.org/10.1093/ajcp/106.2.170  PMID: 8712168 
  14. European Commission. COMMISSION IMPLEMENTING DECISION (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 6.7.2018:L 170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945
  15. Rijksinstituut voor Ziekte- en Invaliditeitsverzekering/Institut National D'Assurance Maladie-Invalidite (RIZIV/INAMI). Reimbursement data 2017. Brussels: RIZIV/INAMI. [Accessed 9 Dec 2019].
  16. Bouthry E, Furione M, Huzly D, Ogee-Nwankwo A, Hao L, Adebayo A, et al. Assessing Immunity to Rubella Virus: a Plea for Standardization of IgG (Immuno)assays. J Clin Microbiol. 2016;54(7):1720-5.  https://doi.org/10.1128/JCM.00383-16  PMID: 27147722 
  17. Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1998;47(Rr-8):1-57.
  18. Lin CC, Yang CY, Shih YL, Huang YY, Yang TH, Liang JY, et al. Persistence and titer changes of rubella virus antibodies in primiparous women who had been vaccinated with strain RA 27/3 in junior high school. Clin Vaccine Immunol. 2012;19(1):1-4.  https://doi.org/10.1128/CVI.05334-11  PMID: 22072722 
  19. Sauerbrei A, Wutzler P. Serological detection of varicella-zoster virus-specific immunoglobulin G by an enzyme-linked immunosorbent assay using glycoprotein antigen. J Clin Microbiol. 2006;44(9):3094-7.  https://doi.org/10.1128/JCM.00719-06  PMID: 16954232 
  20. Dimech W, Grangeot-Keros L, Vauloup-Fellous C. Standardization of Assays That Detect Anti-Rubella Virus IgG Antibodies. Clin Microbiol Rev. 2016;29(1):163-74.  https://doi.org/10.1128/CMR.00045-15  PMID: 26607813 
  21. Kempster SL, Almond N, Dimech W, Grangeot-Keros L, Huzly D, Icenogle J, et al. WHO international standard for anti-rubella: learning from its application. Lancet Infect Dis. 2020;20(1):e17-9.  https://doi.org/10.1016/S1473-3099(19)30274-9  PMID: 31501007 
  22. World Health Organization (WHO). WHO Expert Committee on Biological Standardization. Sixty-eighth report. Geneva: WHO; 2018. Available from: http://apps.who.int/iris/bitstream/handle/10665/272807/9789241210201-eng.pdf?ua=1&ua=1
  23. Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, Ben Mamou M, et al. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clin Microbiol Infect. 2017;23(8):511-5.  https://doi.org/10.1016/j.cmi.2017.04.009  PMID: 28412379 
  24. Centers for Disease Control and Prevention. Elimination of rubella and congenital rubella syndrome—United States, 1969–2004. MMWR Morb Mortal Wkly Rep. 2005;54:279-82.
  25. Isaac BM, Zucker JR, Giancotti FR, Abernathy E, Icenogle J, Rakeman JL, et al. Rubella Surveillance and Diagnostic Testing among a Low-Prevalence Population, New York City, 2012-2013. Clin Vaccine Immunol. 2017;24(9):e00102-17.  https://doi.org/10.1128/CVI.00102-17  PMID: 28701468 
  26. Comité voor de Eliminatie van Mazelen en Rubella in België. Actieplan 2016-2020. [Action plan 2016-2020]. Brussels: Federale Overheidsdienst; 2015. Dutch. Available from: https://overlegorganen.gezondheid.belgie.be/nl/documenten/actieplan-voor-de-eliminatie-van-mazelen-en-rubella-belgie-voor-de-periode-van-2016-2020
Pitfalls of rubella serology while on the brink of elimination: evaluation of national data, Belgium, 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Sofie+Colman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Colman Sofie</a>, <a href="/search?value1=Kris+Vernelen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vernelen Kris</a>, <a href="/search?value1=Bernard+China&option1=author&noRedirect=true" class="nonDisambigAuthorLink">China Bernard</a>, <a href="/search?value1=Dorien+Van+den+Bossche&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van den Bossche Dorien</a>, <a href="/search?value1=Laura+Cornelissen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cornelissen Laura</a>, <a href="/search?value1=Marie-Luce+Delforge&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Delforge Marie-Luce</a>, <a href="/search?value1=Marijke+Reynders&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reynders Marijke</a>, <a href="/search?value1=Mario+Berth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Berth Mario</a>, <a href="/search?value1=Melissa+Depypere&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Depypere Melissa</a>, <a href="/search?value1=Natasja+Van+Gasse&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Gasse Natasja</a>, <a href="/search?value1=Sara+Vijgen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vijgen Sara</a>, <a href="/search?value1=Jos+Van+Acker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van Acker Jos</a>, <a href="/search?value1=An+Boel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boel An</a>, <a href="/search?value1=Elizaveta+Padalko&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Padalko Elizaveta</a></span>. Pitfalls of rubella serology while on the brink of elimination: evaluation of national data, Belgium, 2017. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(20):pii=2000074. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.20.2000074" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.20.2000074</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 29 Jan 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 22 Jun 2020 </span> </p>
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/content/10.2807/1560-7917.ES.2021.26.20.2000074
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