Reinfection after treatment of schistosome infections

Today, chemotherapy has a central role in the control of schistosome infections. Although the costs involved may be high in relation to local expenditures on health, externally funded mass treatment programmes can lead to large reductions in the prevalence and intensity of schistosome infections. But the benefits of treatment to a community that has been involved in a mass chemotherapy programme, or to an individual patient seen in a health centre, will be limited if reinfection after treatment is rapid and intense. Despite the efficacy of the available drugs few, if any, control programmes based on mass chemotherapy have interrupted transmission and come anywhere near to eradicating schistosome infection.     

Retrospective diagnosis of congenital rubella.

One hundred and five children and adolescents with impaired hearing and 19 with impaired vision underwent in vitro tests (lymphocyte responsiveness and serum antibody to rubella) for retrospective diagnosis of intrauterine rubella. Tests yielded results consistent with intrauterine rubella in 30 (29%) of the patients with impaired hearing but only one (5%) of those with impaired vision. In addition, the reported incidence (10.8%) of rubella as a cause of deafness was obtained by questioning parents before the tests. Of 27 patients with impaired hearing of unknown aetiology but reported rubella contact during the pregnancy, seven (26%) had test results consistent with intrauterine rubella. The incidence of intrauterine rubella as a cause of deafness is probably underestimated when the diagnosis is based on the presence of several classic features.     

Increase in congenital rubella occurrence after immunisation in Greece: retrospective survey and systematic review

ObjectiveTo describe the events leading to the epidemic of congenital rubella syndrome in Greece in 1993 after a major rubella epidemic.DesignRetrospective survey and systematic review.SettingGreece (population 10 million), 1950-95.SubjectsChildren, adolescents, and women of childbearing age.ResultsAround 1975 in Greece the measles, mumps, and rubella vaccine started being given to boys and girls aged 1 year without policies to attain high vaccination coverage and to protect adolescents and young women. During the 1980s, vaccination coverage for rubella remained consistently below 50%, and the proportion of pregnant women susceptible to rubella gradually increased. In 1993 the incidence of rubella in young adults was higher than in any previous epidemic year. The epidemic of congenital rubella that followed, with 25 serologically confirmed cases (24.6 per 100 000 live births), was probably the largest such epidemic in Greece after 1950.ConclusionsWith low vaccination coverage, the immunisation of boys and girls aged 1 year against rubella carries the theoretical risk of increasing the occurrence of congenital rubella. This phenomenon, which has not been previously reported, occurred in Greece.     

Evaluation of the incidence of congenital rubella in GDR]

Annual number of congenital rubellas in GDR was evaluated by means of a mathematic model. Dates of inmunity rate of rubella in L. and P. districts obtained by means of haemagglutination inhibition reaction were taken into account. From these dates of a number of possible primary cases of rubella infection in wifes in the first 3 months of pregnancy as well as literary dates on mean number of monsters determined after the infection, i.e. 10--15--25% cases, were evaluated. There were obtained in relation with different mean numbers of monsters 37--56--93 cases of congenital rubellas for live born children from mothers at the age of 14 to 45 years. It results in total that the incidence of disease for live born children from mothers up to 45 years, is 0,2--0,5%, i.e. 2--5 children with congenital rubella on 10 000 live born children. Compared with literary data, it results a good correlation between proper evaluations and numbers of congenital rubella incidence quoted by other authors. In view of these evaluations, a conclusion to introduce protective rubella vaccination, is fully justified.