Incidence of Rubella Antibodies in Female Subjects

Sera from females aged 1 to 40 years were assayed for rubella virus antibodies. Results showed that by age 14 years, 60% had antibodies and that by 19 years, 70% were positive. This figure rose to 80% by 24 years of age and remained unchanged in older age groups.A comparison of the incidence of high and low levels of antibodies in each age group revealed that antibody levels fell between ages 20 and 40 years. Only 20% of individuals in the latter group had a high antibody level compared to 80% in the former.These results are discussed as they relate to the problems of reinfection and possible vaccination procedures.     

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.     

The significance of specific IgM antibody in the diagnosis of rubella employing the immunofluorescence technique

The applicability of the immunofluorescence (IF) test to the diagnosis of primary rubella infection was investigated. The test is based on the detection of rubella-specific antibodies in the IgM fraction of immunoglobulins. The results indicate the usefulness of the IF test for the diagnosis of primary rubella infection on a single serum specimen collected at a proper time. The test is also of value in the differentiation of primary infection from reinfection, since in reinfection no rubella-specific antibodies are found in the IgM fraction. The test is also valuable for the detection of fetal infection in utero since the persistence of IgM antibodies in pregnant women is indicative of fetal infection.     

Fetal infection after maternal reinfection with rubella: criteria for defining reinfection.

Five cases of asymptomatic maternal reinfection with rubella are described that occurred in England and Wales during 1985-8 and resulted in intrauterine infection. The criteria for diagnosing reinfection are described. In four cases the rubella contact was with the woman''s own children. Two women had therapeutic abortions, rubella virus being recovered from the products of conception, and three were delivered of infants with congenitally acquired disease. Though the risks associated with maternal reinfection with rubella are very small and being measured in a prospective study, it is hoped that the recently introduced augmented programme of rubella vaccination will reduce rubella in the community and therefore this small risk still further.     

The use of ion exchange chromatography for demonstration of rubella-specific IgM antibodies

IgM and IgG immunoglobulins of human sera were separated by stepwise column chromatography in QAE-Sephadex A-25 ion exchanger gel bed. The procedure resulted within 30 min in a fraction suitable for direct titration of rubella-specific IgM antibodies by haemagglutination inhibition test. The method proved to be a useful diagnostic tool for primary rubella. Serum samples of 13 individuals with previously acquired immunity, 152 patients with a recent rubella-like illness, and 194 pregnant women exposed to rubella infection were tested for the presence of rubella-specific IgM antibodies. Sera of individuals with previous immunity proved to be negative for specific IgM antibodies. Specific IgM titre was demonstrated in the blood of all the 25 patients with significant titre-rise tested because of rubella-like illness, and also in the sera of additional 8 patients whose serum samples were taken too late for demonstration of a rise in titre. Significant titre-rises were found in 5 women exposed to rubella infection, but only two of them exhibited rubella-specific IgM antibodies. The absence of specific IgM antibodies refers presumably to subclinical reinfection in the other three cases.     

Rubella Virus Infections During Pregnancy,Toronto, 1963-66

Among 670 pregnant women who attended the antenatal clinics of two Toronto city hospitals and one suburban hospital between May 1963 and January 1966, 29 of 550 patients apparently acquired rubella neutralizing antibodies, including 12 whose initial sera were collected during the first trimester. None developed overt rubella. Although rubella antibodies were detected in 61 to 79% of mothers aged 20 years or more, and antibody conversions were detected in 4 to 10% of mothers in each five-year age group between 16 and 39 years, tho rubella syndrome did not appear among any of their offspring. Five of seven other infants, aged 4 to 22 weeks, with the rubella syndrome excreted rubella virus. Rubella neutralizing antibodies were detected in all seven of these infants; these persisted at least 56 weeks in one subject. One mother who received gamma globulin during the first trimester was delivered of an infant who showed signs of the rubella syndrome.     

Avidity of immunoglobulin G to rubella virus in post-vaccination and post-infection immunity

Comparative evaluation of avidity of IgG to rubella virus in vaccinated persons, in patients with rubella or other exanthematous illness, and in healthy persons revealed similar patterns in post-vaccination and post-infection immunity. Virus specific low avidity IgG (index of avidity < or =30%) were detected in patients with rubella during 7 weeks after symptoms appeared as well as in vaccinated persons which were tested 6 weeks after vaccination. Low avidity antibodies in sera were detected in 96% of patients with rubella and in 75% of vaccinated persons which were not immune before immunization. Live attenuated vaccines Ervevax, Priorix, and MMR-II had similar ability to induce low avidity IgG to rubella virus. Increase of low avidity antibodies concentration was noted after immunization of children with low levels of antibodies before vaccination. After immunization of persons with high avidity antibodies in serum, index of avidity remained above threshold. Anamnestic high avidity IgG (index of avidity 51-100%) were detected in majority of immune healthy persons (96.4%) as well as in patients with exanthematous illnesses not related to rubella infection (93.6%). ELISA test-systems for detection of low avidity IgG to rubella virus allow to obtain reliable information about seroconversion rate and characteristics of immune response in vaccines. Detection of low avidity IgG in serum obtained 5-6 weeks after immunization points to primary immune response, whereas identification of high avidity antibodies reveals already immune persons.     

Immunity in human schistosomiasis mansoni: cross-reactive IgM and IgG2 anti-carbohydrate antibodies block the expression of immunity

We have previously reported that the slow development of immunity to reinfection after treatment of Schistosoma mansoni infections is partly attributable to the continued presence of 'blocking' antibodies in young, susceptible children. A further analysis of this phenomenon supports the hypothesis that such blocking antibodies can be of the IgG2 as well as the IgM isotype, and that they react with carbohydrate epitopes expressed both on egg polysaccharides and on schistosomulum surface antigens, of particular importance being those antigens that are shed from the schistosomulum surface during the early stages of maturation in vitro. Evidence is also presented that, in those patients lacking high levels of IgG2 blocking antibodies, resistance to reinfection after treatment is associated with the presence of other IgG isotypes against the same shed antigens.     

Seroprevalence of measles-, mumps- and rubella-specific IgG antibodies in german children and adolescents and predictors for seronegativity

We have undertaken a seroprevalence study with more than 13,000 children, who had been included in the German KIGGS survey, a representative sample of children and adolescents 0-17 years of age. The IgG titres against measles, mumps and rubella were determined in 1 to 17 year olds While 88.8% of the children were MMR-vaccinated at least once, 76.8% of children aged 1 to 17 years showed prevalence of antibodies to MMR. The highest seronegativity was seen with respect to mumps. Gender differences were most pronounced with regard to rubella IgG titres: girls aged 14 to 17 years were best protected, although seronegativity in 6.8% of this vulnerable group still shows the need of improvement. Search for predictors of missing seroprevalence identified young age to be the most important predictor. Children living in the former West and children born outside of Germany had a higher risk of lacking protection against measles and rubella, while children with a migration background but born in Germany were less often seronegative to measles antibodies than their German contemporaries. An association of seronegativity and early vaccination was seen for measles but not for mumps and rubella. A high maternal educational level was associated with seronegativity to measles and rubella. In vaccinated children, seronegativity was highest for mumps and lowest for rubella. For mumps, high differences were observed for seronegativity after one-dose and two-dose vaccination, respectively. Seronegativity increases as time since last vaccination passes thus indicating significant waning effects for all three components of MMR.     

Silent thyroiditis following rubella

A 40-year-old housewife was referred to our hospital for evaluation of a thyrotoxic state. A month after rubella infection, she developed heat intolerance. Physical examination revealed a hard and non-tender goiter with no signs or symptoms of inflammation. Free thyroid hormones were high and TSH was undetectable. 123I-thyroidal uptake was suppressed. Antithyroglobulin and anti-microsomal antibodies were negative throughout the course. A serologic study revealed high levels of anti-rubella antibodies. After a month without any treatment, she became euthyroid. Free thyroid hormones and TSH gradually became normal and the antibodies to rubella decreased. 123I-thyroidal uptake increased. From the clinical course, the patient was diagnosed as having silent thyroiditis. We suggest that viral infection such as rubella could cause the development of silent thyroiditis.     

IgM antibodies in rubella infections: absorption with staphylococcal protein A of sera examined by immunofluorescence and haemagglutination inhibition.

A similar frequency of positive results for rubella IgM antibodies in the sera of rubella patients and persons contacting such patients was obtained by immunofluorescence after separation of IgM is sucrose gradient and after absorption of the sera with Staphylococcus aureus and immunoglobulin aggregates. Compared to the immunofluorescence method, the haemagglutination method for rubella IgM antibodies performed after absorption of the sera with S. aureus and reduction of immunoglobulins M with 2-mercaptoethanol was less sensitive for serum samples taken in the acute phase of the disease and 5 weeks after the appearance of rubella symptoms.     

Influence of the Intestinal Flora on the Development of Immune Reactions in Infants

Breast-fed and artifically fed infants are in contact with the O antigen of Escherichia coli from the first days after birth. From the mother, the infant obtains antibodies against nonpathogenic E. coli strains in low titer, and the infant begins to form its own antibodies during the 2nd month of life. The transition is known to be continuous even though the transferred antibodies could not be differentiated from the infant's own antibodies. Contact with endotoxin caused sensitization which was detected by the skin test at about 2.5 months, and thereafter the skin test data correlated with the presence of serum antibodies against endotoxin. The newborn infant can be colonized with a different E. coli serotype; such an antigenic stimulus evokes the formation of antibodies sooner and at a significantly higher titer than (i) the level of maternal antibodies transferred or (ii) the infant's antibodies normally formed later on against other random E. coli serotypes.     

Rubella-neutralizing and haemagglutinin-inhibiting antibodies in children of different ages

Rubella neutralization and haemagglutinin-inhibition tests were used to determine the incidence of rubella antibodies in the sera of 235 children and adolescents aged 1 month to 20 years. The tests showed good agreement in the detection of rubella antibodies resulting from acute infection. Maternal antibodies became undetectable within six months after birth. The proportion of children possessing rubella antibodies was found to be about 23% by the age of 5 years, rising sharply to 80% in the 6–12 years age group and 83% in the 13–20 years age group. Results indicate that the incidence of rubella infection may be higher in females than in males. The correlation between statements concerning a past history of rubella and immune status was poor, particularly in the older age groups. Any policy for vaccination against rubella must take into account the difficulties of identifying nonimmune persons in a large population.     

Diaplacental passage of Sarcocystis antibodies in man and rats (author's transl)]

Sera of babies up to the age of 3 months were tested for Sarcocystis antibodies using the indirect immunofluorescence test (IIFT). In addition titre of the Sarcocystis antibody level of litters born to serologic Sarcocystis positive mother rats was compared to those of their mothers. The results are as follows: 1. 45 (= 14.6%) out of 308 sera from babies up to the age of 3 months reacted positively in the Sarcocystis antibody test. 2. 28 (= 62.2%) out of the 45 positive sera were from babies up to 2 weeks old, 13 (= 28.9%) were from babies older than 2 weeks but not more than 4 weeks old, and 2 (=4.4%) each were from babies whose ages ranged from 4 to 8, and 8 to 12 weeks respectively. 3. These babies acquired their Sarcocystis antibodies which decreased in the first 3 months of life from their mothers. 4. Litters born to serologic Sarcocystis positive mother rats also demonstrated Sarcocystis antibodies. The titres of these antibodies were at the same level as their mothers' at birth but reduced gradually so that most of these young rats were negative at the age of 3 months. 5. Suckling rats born to Sarcocystis negative mothers but positive fathers remained negative. 6. Serologic positive mother and father rats still demonstrated Sarcocystis antibodies in the sera at a time when their litters have become negative. 7. Sarcocystis antibodies could be passed onto the newborn from their positive mothers in both man and rats. 8. These antibodies were probably passed onto the newborn through the placenta but their passage through the colostrum and the mother's milk cannot be ruled out.     

Study of interaction between IgG and IgM antibodies against rubella virus by the immunofluorescence method.

In immunoglobulin fractions or after elimination of IgG by absorption the immunofluorescence test for rubella IgM antibodies is more sensitive than in whole serum. Blocking of IgM activity by IgG antibodies was eliminated when the time of incubation of the serum with virus antigen was prolonged. After prolonged incubation higher titres of rubella antibodies were also obtained in the IgM immunoglobulin fractions. Protein A in Staphylococcus aureus suspension effectively absorbs antibodies of IgG class. The IgM antibody titres in absorbed sera of patients infected with rubella were in some cases 2 to 4 times higher than in unabsorbed sera.     

Interferon γ in acute and subacute encephalitis

Intrathecal synthesis of interferon γ was shown in 14 out of 16 samples of cerebrospinal fluid collected in the first days of disease in adults, children, and newborn infants with herpes encephalitis. This synthesis was concomitant with that of interferon α and was switched off when the specific antibodies in the central nervous system increased. No endogenous interferon γ was detected in 11 serum samples or 13 samples of cerebrospinal fluid collected early in the course of the disease from patients with measles encephalitis and rubella encephalitis, or in serum and cerebrospinal fluid samples from seven patients with subacute sclerosing panencephalitis. In serum collected after the 10th day after the onset of neurological symptoms interferon γ was present at low concentrations in only three out of 11 serum specimens from patients with measles encephalitis or rubella encephalitis.Interferon γ was present in patients with acute herpes encephalitis and there was active virus replication, but it was not present in postinfectious encephalitis. Possibly the local production of specific antibodies masks the viral antigens and switches off the induction of interferons.     

Correlation between circulating biomarkers of oxidative stress of maternal and umbilical cord blood at birth

The objective of the work was to study the relationship between the oxidative state of the mother and the newborn at the moment of birth. We measured oxidative stress markers (carbonyl groups, lipid peroxides and total antioxidant capacity (TAC)) and found a good correlation between the oxidative state of the normal mother and the neonate, since a high mother oxidative stress corresponds to an even higher oxidative stress of the newborn in umbilical cord blood. We also found that smoking mothers and their newborns had a higher concentration of the carbonyl group, lipid peroxides and less TAC. Newborns from these mothers weighed significantly less than others at birth. These data suggest a need for interest in monitoring the oxidative state of mothers during the pregnancy period, especially taking into account that the oxidative level could be involved in later risks of metabolic diseases for both mother and newborn.     

Correlation between circulating biomarkers of oxidative stress of maternal and umbilical cord blood at birth

The objective of the work was to study the relationship between the oxidative state of the mother and the newborn at the moment of birth. We measured oxidative stress markers (carbonyl groups, lipid peroxides and total antioxidant capacity (TAC)) and found a good correlation between the oxidative state of the normal mother and the neonate, since a high mother oxidative stress corresponds to an even higher oxidative stress of the newborn in umbilical cord blood. We also found that smoking mothers and their newborns had a higher concentration of the carbonyl group, lipid peroxides and less TAC. Newborns from these mothers weighed significantly less than others at birth. These data suggest a need for interest in monitoring the oxidative state of mothers during the pregnancy period, especially taking into account that the oxidative level could be involved in later risks of metabolic diseases for both mother and newborn.     

Trypanosoma rangeli Tejera, 1920. VIII. Response to reinfections in 2 mammals

Under experimental conditions, the course of the infection and the response to the reinfection by Trypanosoma rangeli in mice and Didelphis marsupialis, are studied. During the initial infection the mice show a relatively low parasitaemia and a short patent period. A scanty parasitaemia level of four days length, was observed following the first reinfection, being the mice resistant to new reinfections by T. rangeli. In opossums a lower parasitaemia and a longer patent period than that detected in mice, were observed during the initial infection. The response to reinfections in this mammal, was similar to that observed in mice. After reinfection with T. rangeli, haemagglutinant antibodies in immune-sera of both mice and opossums, were detected. The possible immune-response at the site of deposition against the metacyclic-forms of T. rangeli, and the action of circulating antibodies against the blood forms of the parasite, are speculated to explain the resistance of mice and opossums to the reinfection by T. rangeli.     

Antibodies to Streptococcus pneumoniae antigens in newborn infants

The levels of antibodies to capsular polysaccharide antigens of pneumococci (serotypes 1, 3, 6B, 8, 9N, 15F, 23F), C-polysaccharide and protein antigen of pneumococci in the blood sera of 38 newborn infants at the moment of their birth (umbilical blood) and on the 5th or 6th day of their life, in their mothers' blood sera, as well as in the colostrum and milk of 48 nursing women, have been studied by means of the enzyme immunoassay. The study showed that in the normal course of pregnancy antibodies to pneumococci were transferred transplacentally from the mother to the fetus. Though in most cases their content in the blood of newborn infants was lower than that in maternal blood, it exceeded the average level of antipneumococcal antibodies in children aged 3-12 months. In the milk of nursing mothers considerable amount of IgA antibodies to pneumococci was detected, which might be an additional protective factor with respect to pneumococcal infection in infants.