title: Congenital rubella syndrome (CRS) in Vietnam 2011-2012--CRS epidemic after rubella epidemic in 2010-2011.
abstract: BACKGROUND
  Rubella is endemic in Vietnam with epidemics occurring every 4-5 years. In 2011, Vietnam experienced the large nationwide rubella epidemic. During the rubella epidemic, many infants born with congenital rubella syndrome (CRS) were identified and reported from the neonatal units or cardiology departments of the national hospitals. To understand the burden of CRS, National Expanded Program on Immunization (NEPI) established sentinel CRS surveillance system.
  
  
  METHODS
  Three national paediatric hospitals in Hanoi and Ho Chi Minh City (HCMC) were selected as CRS sentinel surveillance sites. Blood specimens from the infants were collected for rubella specific IgM and ELISA testing was performed at the national measles and rubella laboratory.
  
  
  RESULTS
  From January 2011 to December 2012, 424 infants with suspected CRS were identified and reported. Among them 406 (96%) had specimens obtained, 284 (70%) cases were IgM positive including 279 laboratory confirmed CRS and 5 Congenital Rubella Infection (CRI). 13 cases were clinically confirmed and 127 (30%) were discarded. Total 292 infants were confirmed as CRS. Of the 292 infants with CRS, 69% of mothers had a history of "fever and rash" during pregnancy, of which 85% was in the first trimester. The most common clinical defects were congenital heart disease and cataract(s). However, 81.9% of the infants had a combination of major and minor signs and symptoms. Low birth weight in full term infants with confirmed CRS was observed in 114 infants (39%).
  
  
  CONCLUSIONS
  The newly established CRS sentinel surveillance system documented the significant burden of CRS in Vietnam and provided evidence to the policy makers for the introduction of rubella containing vaccine (RCV) into Vietnam. This report highlights the importance of countries with rubella epidemic to establish CRS surveillance rapidly in order to support the introduction of RCV into the routine Expanded Programme on Immunization (EPI) immunization.
authors.affiliation: WHO Country Office, Hanoi, Viet Nam. Electronic address: todak@wpro.who.int.
authors.forename: Kohei
authors.initials: K
authors.lastname: Toda
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Reef
authors.affiliation: WHO Country Office, Hanoi, Viet Nam.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tsuruoka
authors.affiliation: WHO Country Office, Hanoi, Viet Nam.
authors.forename: Makiko
authors.initials: M
authors.lastname: Iijima
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Thanh Huyen
authors.initials: TH
authors.lastname: Dang
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Thi Hong
authors.initials: TH
authors.lastname: Duong
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Van Cuong
authors.initials: VC
authors.lastname: Nguyen
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
authors.forename: Tran Hien
authors.initials: TH
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D062665:Epidemiological Monitoring; D005260:Female; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M
keywords: CRS; CRS surveillance; Congenital rubella syndrome; RCV; Routine EPI immunization; Rubella