Re-emergence of rubella during pregnancy: 11 cases in Clermont-Ferrand in 1997

OBJECTIVE: Describe the clinical and laboratory features of rubella observe d during the first semester of pregnancy in 11 patients in 1997. PATIENTS AND METHODS: Eleven pregnant women, aged 15 - 30 years, were refer red to the Clermont-Ferrand University Hospital for suspected rubella. Four had had at least 1 prior pregnancy, none had been vaccinated. Rubella sero logy was obtained for all 11 patients and polymerase chain reaction viral a mplification was performed on amniotic fluid in 9 cases. RESULTS: The virology laboratory identified 8 cases of primary rubella (2 p rior to 12 weeks gestation) and 3 reinfections (1 prior to 12 weeks gestati on). Fetal infection was evidenced in 1 gravida II patient at 17-18 weeks g estation. All pregnancies were continued to term and no case of congenital rubella malformation was observed. However specific IgM assays were perform ed at birth in 6 of the 11 infants and revealed infection in 3. CONCLUSION: These observations indicate that a local epidemic of rubella oc curred in the general population. They illustrate the risk of a rubella epi demic in France and the lack of sufficient vaccination of the young adult p opulation, finally they emphasize that current anti-rubella vaccination pro grams should be promoted.