• Journal of Korean Public Health Nursing
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• v.13 no.1
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• pp.88-96
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• 1999

This study was conducted in May of 1996 to December of 1996 in order to investigate the status of rubella antibodies in the women of childbearing age. The subjects were 543 fertile women (Ages 21-42 years). ELISA method was used for the detection of rubella antibodies and then questionaire survey was performed to know about the variables of past history of rubella. past rubella immunization. parity and cognition. The results were as follows: 1. The Positive rate of rubella Ig G antibody in total subjects was $65.0\%$. The positive rate of rubella Ig G antibody was $72.2\%$ in 21-25 age group. $71.4\%$ in 26-30 age group. $54.5\%$ in 31-35 age group, $52.6\%$ in 36-42 age group. As age increased, the positive rate of rubella Ig G antibody was decreased. There was statistically significant difference by age group(P=0.00l). In the subjects with a history of rubella immunization, the positive rate of rubella IgG antibody was $81.8\%$, and in those with past history of rubella was $83.3\%$ of positive rate. 2, Cognition rate about rubella immunization showed $50.8\%$ in total subjects. and there was no significant difference between parity and cognition rate of rubella immunization(P=0.85l). observed a low positive rate of rubella IgG antibody as compaired with other studies. Therefore, to prevent congenital rubella infection, rubella immunization was needed for unmarried women.

• Journal of Preventive Medicine and Public Health
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• v.33 no.3
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• pp.280-284
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• 2000

Background : Congenital rubella syndrome (CRS) can be controlled by vaccination. Because rubella is typically a childhood disease, occurring predominantly in the 5 to 14 year age group, female school teachers nay be a high-risk population for CRS. Objectives : To determine the prevalence rate of rubella antibodies in school teachers of child bearing age. Methods : The study population consisted of primary, middle and high school teachers of child bearing age. The subjects were aged 35 years and younger, and consented to immunoglobulin (Ig) level testing using the ELISA method. Results : The positive rate of IgG was 77.9% in the study subjects (n=314). Sixty-three teachers (21.4%) were susceptible to rubella infection. Thirty-seven teachers (11.8%) had a history of rubella vaccination. Among the female teachers with no vaccination history, the proportion of negative IgM and IgG was 21.7%, and the proportion of positive IgM was 2.9%. Seventy-nine percent of the study subjects did not know that they should not become pregnant for three months after receiving the rubella vaccine. Conclusion : School teachers of child bearing age should be considered a high risk group for CRS, and should be vaccinated if they are found to be seronegative.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.115-122
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• 2013

Reemerging infectious diseases are infections that had decreased in incidence in the global population and were brought under control through effective health care policy such as vaccination, but more recently, began to resurge as a health problem due to many reasons. Measles, rubella, mumps and pertussis are the examples. Immunization with MMR (measles, mumps, rubella) and pertussis vaccine has contributed to marked decrease in measles, mumps, rubella and pertussis incidence worldwide. In Korea, measles and rubella almost disappeared after the introduction of 2 doses of MMR immunization schedule. Recently, these infections have been reemerging in many countries with low vaccination rates and can be introduced again in Korea. However mumps and pertussis outbreaks are reported among fully vaccinated populations. Declining vaccine effectiveness, an increased awareness and surveillance of the disease or improved laboratory diagnostic tools had been suggested as possible causes. For the clinicians, it is difficult to diagnose these reemerging infectious diseases partly because of few experience of typical cases of measles and rubella or partly because of modification of clinical symptoms and signs of infectious diseases in immunized population. In this article, the diagnosis of measles, mumps, rubella and pertussis will be reviewed in the aspects of clinical characteristics, serologic methods, virus isolation, and polymerase chain reaction.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.337-365
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• 1994

Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.279-292
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• 1997

The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We could not estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer $Abbott^(R)$. The infected pregnant women followed up in order to confirm their childrens CRS. This study was carried out from Mu. 1993 to Jun. 1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive .ate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with .ash, 13.5% only URI symptoms without .ash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection .ate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec. 1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.

• The Journal of the Korean Society for Microbiology
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• v.22 no.4
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• pp.473-483
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• 1987

Present study was undertaken to find when is right time for vaccination against Measles, Mumps and Rubella and what is the seropositive conversion rate after those vacinations. For this purpose, sera from 106 infants and children adimitted in Prediatric Department of Won Kwang University Hospital, Iri, Chonbuk, Korea were divided into 3 groups, such as (1) Vaccination group with definite information when it was given, (2) Unknown group whether vaccination was given or not, (3) Not vaccinated group. They were tested of IgG and IgM antibodies against Measles, Mumps and Rubella using Enzyme Immunoassay method and the following results were obtained. 1. Infants below 6 month of age showed to have IgG antibodies which seemed to have been transferred from mother in 87.8%(29/33) for Measles, 78.8%(26/33) for Mumps and 39.4%(13/13) for Rubella. And they showed IgM antibodies which are thought to have been produced by recent infection in 24.2%(8/33) for Measles, 48.5%(16/33) for Mumps and 9.1%(3/33) for Rubella. 2. Positivity of antibody IgG against Rubella was observed remarkably lower than it is against Measles and Mumps being only 39.4%(13/33) in $0{\sim}5$ month, 30.8%(8/26) in $6{\sim}11$ months, 30%(3/10) in $12{\sim}14$ months and 62.9%(22/35) in $18{\sim}36$ months of age. 3. ${\Delta}OD's$ of IgG and IgM antibodies against Measles were observed increasing with age being 0.444, 0.220 in $0{\sim}5$ months, 0.326, 0.134 in $6{\sim}11$ months, 0.581, 0.140 in $12{\sim}14$ months, 0.512, 0.000 in $15{\sim}17$ months and 0.887, 0.278 in $18{\sim}36$ months of age, respectively. 4. ${\Delta}OD's$ of IgG and IgM antibodies against Mumps were observed increasing with age being 0.427, 0.340 in $0{\sim}5$ months, 0.400, 0.249 in $6{\sim}11$ months, 0.694, 0.314 in $12{\sim}14$ months, 0.539, 0.165 in $15{\sim}17$ months and 0.854, 0.350 in $18{\sim}36$ months of age, respectively. 5. Vaccination for Measles, Mumps and Rubella is generally to start at 15 months of age in Korea, by which age their antibodies are found to exsist in more than 80% of tested samples. So, it seems to be very reasonable to start the vaccination schedule at earlier age than it does currently. 6. From the present study, it seems to have been clearly confirmed that Enzyme Immunoassay method is a reliable method with good reproducibility for mass survey of IgG and IgM antibodies against Measles, Mumps and Rubella in infants and children.

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.117-123
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• 2011

Purpose : We investigated the change of antibody titer to measles, mumps and rubella according to age after vaccination. Methods : The IgG antibody titers to measles, mumps and rubella were tested on the residual serum from patients aged 7-20 years old after routine laboratory testing in the hospital with informed consent from the parents. Results : Antibody to measles was present in 275 cases out of 408 cases with a positive rate of 67.4%, the mean IgG titer was 2.77${\pm}$1.18 Index. Antibody to mumps was present in 112 cases out of 408 cases with a positive rate of 27.5%, the mean IgG titer was 2.08${\pm}$1.29 Index. Antibody to rubella was present in 367 cases out of 408 cases with a positive rate of 90.0%, the mean IgG titer was 60.46${\pm}$63.47 IU/mL. Conclusion : It is important to maintain a high rate of vaccination coverage in order to prevent an outbreak of measles, mumps, or rubella. It is also important to stress the maintenance of vaccination records for further reference.

• The Journal of Korean Society of Virology
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• v.30 no.1
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• pp.51-59
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• 2000

During the recent epidemic period ($1995{\sim}1996$), seven strains of rubella virus were isolated in Korea. To analyze phylogenetic relationship between seven Korean strains and rubella virus strains from other different geographical areas, structural genes (E1, E2 and C) of Korean strains were enzymatically amplified and automatically sequenced. The sequence similarities of the E1, E2 and C genes of the cosmopolitan types were $95.8{\sim}98.1%$, $92.6{\sim}99.2%$ and $96.4{\sim}99.3%$ based on 1,441, 122 and 139 nucleotides and $96.9{\sim}98.5%$, $90{\sim}100%$ and $97.8{\sim}100%$ based on 480, 40 and 46 amino acids compared to the sequences of strain RA27/3, respectively. In contrast, the sequence similarities of the E1, E2 and C genes of the Asian types were $91.5{\sim}92.1%$, $83.6{\sim}88.5%$ and 91.4% based on nucleotides and $96.9{\sim}97.7%$, 85.5% and 97.8% based on amino acids compared to the sequences of strain RA27/3, respectively. However, immunodominent epitopes of the E1 gene of the cosmopolitan and Asian types were well conserved, and the growth patterns in cell culture and immunofluorescent antibody titers in cross-reaction test showed no differences between two different types. In phylogenetic analysis based on nucleotide sequences of each gene regions, the cosmopolitan and Asian types formed two distinct phylogenetic lineages. These data showed two distinct genotypes of rubella viruses cocirculated in Korea, but no significant differences in the antigenicity of two different rubella virus strains were found.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.175-184
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• 1996

Purpose : This study was intended to measure seropositivities and the levels of mumps- and rubella-specific IgG of MMR vaccinees over 17 months of age in Korea. Materials and Methods : From June 1994 to April 1995 we obtained sera from visitors of well baby clinic and patients in Korea University Hospital, who were MMR vaccinees over 17 months of age and had no evidence of immunodeficiency. These 275 study population include 145 males and 130 females. Mumps- and rubella-specific IgG antibody levels were measured by ELISA. Cut-off values for seropositivity were 20 GU(Gamma Unit) in mumps and 0.17 in rubella. Results : 1) As age increased, seropositivities of mumps-specific IgG increased significantly, being 69.0% in 1.5~2 year, 75.0% in 3~4 year, 76.0% in 5~6 year, 90.0% in 7 year, 100% in 8 year, 96.9% in 9 year, 97.4% in 10 year, 97.4% in 11 year, and 96.6% in 12 year of age(p<0.001). 2) As age increased, the levels of mumps-specific IgG antibody(mean${\pm}$standard deviation, GU) increased significantly, being $64.9{\pm}66.5$ in 1.5-2 year, $117.7{\pm}126.4$ in 3~4 year, $152.3{\pm}147.1$ in 5~6 year, $194.3{\pm}168.2$ in 7 year, $258.1{\pm}190.6$ in 8 year, $193.1{\pm}130.1$ in 9 year, $225.7{\pm}119.6$ in 10 year, $220.7{\pm}114.3$ in 11 year, and $222.3{\pm}127.1$ in 12 year of age(p<0.001). There was positive correlation between age and mumps-specific antibody level (r=0.3282, p<0.001). 3) As age increased, seropositivities of rubella-specific IgG decreased significantly, being 72.4% in 1.5~2 year, 75% in 3~4 year, 72% in 5~6 year, 60% in 7 year, 44.4% in 8 year, 40.6% in 9 year, 28.2% in 10 year, 23.1% in 11 year, and 17.2% in 12 year of age(p<0.001). 4) As age increased, rubella-specific IgG decreased significantly, being $0.462{\pm}0.356$ in 1.5~2year, $0.438{\pm}0.306$ in 3~4 year, $0.287{\pm}0.179$ in 5~6 year, $0.204{\pm}0.139$ in 7 year, $0.189{\pm}0.153$ in 8 year, $0.124{\pm}0.121$ in 9 year, $0.093{\pm}0.114$ in 10 year, $0.104{\pm}0.135$ in 11 year, and $0.080{\pm}0.001$ in 12 year of age(p<0.001). There was negative correlation between age and rubella-specific IgG titer (r=-0.551, p<0.001). Conclusions : Eventhough seropositivities and the level of mumps-specific IgG increased as age increased, they are not enough to prevent mumps infection in 1.5 to 6 years of age. Seropositivities and the level of rubella-specific IgG decreased as age increased. Appropriate change in vaccine schedule may be needed to decrease the risks of mumps and rubella infection.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.128-135
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• 1998

Purpose : This study was intended to measure seropositivities and the level of mumps- and rubella-specific IgG of MMR vaccinees from 12 to 17 years of age in Korea. Materials and Methods : From May 1996 to July 1996 we obtained sera from students of 1 middle and 2 high schools in Seoul, who were MMR vaccinees from 12 to 17 years of age and had no evidence of immunodeficiency. These 216 study population include 110 males and 106 females. Mumps- and rubella-specific IgG antibody levels were measured by ELISA. Cut-off values for seropositivity were 20 U(Gamma Unit) in mumps and over 0.17 in rubella. Results : 1) As age increased, seropositivities to mumps increased, being 68.4% in 12 year, 79.3% in 13 year, 72.2% in 14 year, 82.0% in 15 year, 87.5% in 16 year, 87.0% in 17 year, which however has no statistical significance. 2) As age increased, the level of mumps-specific IgG antibody(mean+standard deviation, GU) increased, being $52.0{\pm}49.2$ in 12 year, $65.9{\pm}51.4$ in 13 year, $71.1{\pm}66.0$ in 14 year, $67.8{\pm}53.6$ in 15 year, $82.8{\pm}67.8$ in 16 year, $92.0{\pm}68.9$ in 17 year, which however has no statistical significance. 3) As age increased, seropositivities of rubella-specific IgG increased significantly, being 26.3% in 12 year, 20.7% in 13 year, 50.0% in 14 year, 67.2% in 15 year, 66.7% in 16 year, 65.2% in 17 year(P<0.001). 4) As age increased, rubella-specific IgG increased significantly, being $0.13{\pm}0.145$ in 12 year, $0.087{\pm}0.101$ in 13 year, $0.194{\pm}0.168$ in 14 year, $0.260{\pm}0.187$ in 15 year, $0.305{\pm}0.213$ in 16 year, $0.325{\pm}0.221$ in 17 year(P<0.001). There was positive correlation between age and rubella-specific IgG titer(rubella-specific $IgG=0.0517{\times}age-0.5586$, r=0.3752, P<0.001). Conclusion : In adolescent, seropositivities and the level of mumps-specific IgG remained relatively high, but approximately 20% of study population showed seronegativity. Seropositivities and the level of rubella-specific IgG showed the lowest level at 13 years of age and were increased with age after 14 years of age. Further evaluation may be needed to elucidate the cause of these changes of rubella-specific IgG.