Rubella serosurveys at three Aravind Eye Hospitals in Tamil Nadu, India
Vijayalakshmi, P.; Anuradha, R.; Prakash, K.; Narendran, K.; Ravindran, M.; Prajna, L.; Brown, D.; Robertson, S.E.
Bulletin of the World Health Organization 82(4): 259-264
2004
ISSN/ISBN: 0042-9686 PMID: 15259254 Document Number: 233317
Objective: To determine the susceptibility of female eye hospital staff to rubella infection and the potential risk for hospital-based rubella outbreaks. Methods: From May to December 2002, a prospective cohort study on the seroprevalence of rubella immunoglobulin (Ig)G antibodies was conducted at three large eye hospitals (Aravind Eye Hospital) in Coimbatore, Madurai and Tirunelveli, in Tamil Nadu, India, where young children with eye abnormalities attributable to congenital rubella are treated. A total of 1000 female hospital employees aged 18-40 years agreed to participate and gave written informed consent. Findings: The proportions of rubella-seronegative women were: 11.7% at Coimbatore, with a 95% confidence interval (CI) of 8.1-16.5; 15% at Madurai (95% CI=12.3-18.1), and 20.8 at Tirunelveli (95% CI=14.7-28.6). For the entire cohort the proportion seronegative was significantly higher among married women (21.5%) than among single women (14.0%) (P=0.02). Rates of seronegativity were highest among physicians and lowest among housekeepers. All 150 seronegative women in the study sample accepted a dose of rubella vaccine. Conclusion: These are the first rubella serosurveys reported from eye hospitals in any country. The relatively high rate of susceptibility indicates a risk of rubella outbreak, and this is reduced by vaccinating all seronegative women. A policy has been established at all three hospitals for the provision of rubella vaccine to new employees. Other hospitals, especially eye hospitals and hospitals in countries without routine rubella immunization, should consider the rubella susceptibility of staff and the risk of hospital-based rubella outbreaks.