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Rubella outbreak in Thailand 1983-1984: a study at Siriraj Hospital
Abstract:
The recent rubella epidemic in Thailand prevailed from September 1983 to August 1984 with its peak in March. Throughout the outbreak, approximately 70% of the cases diagnosed clinical rubella were laboratory proved. In the middle of the outbreak, accuracy of the clinical diagnosis was 75-87%, while it was 25-33% at the beginning and the end. Concerning the clinical findings in rubella, maculopapular rash may be generalized or localized, and lymphadenopathy occurred only in 40% of the clinical cases. Lymphadenopathy and respiratory symptoms appeared 3 times more frequent than those in the non-rubella cases. Rubella inapparent infection occurred in 5.14% of the contact cases. Acquisition of the disease after contact did not depend on the degree of close relationship between the index cases and the contact cases. Outcome of pregnancy and congenital rubella infection after the outbreak have to be further investigated.
Insights
During Thailand's 1983-1984 rubella epidemic, clinical diagnosis accuracy varied significantly, with laboratory confirmation available for 70% of suspected cases. Further investigation is needed for pregnancy and congenital rubella outcomes.
Area of Science:
- Epidemiology
- Virology
- Public Health
Background:
- A significant rubella epidemic occurred in Thailand between September 1983 and August 1984.
- Rubella diagnosis relies on clinical presentation and laboratory confirmation.
Purpose of the Study:
- To analyze the clinical diagnosis accuracy during the rubella epidemic.
- To describe clinical findings and transmission patterns of rubella.
- To assess the incidence of inapparent rubella infections.
Main Methods:
- Retrospective analysis of clinical and laboratory data from rubella cases.
- Comparison of clinical findings between rubella and non-rubella cases.
- Investigation of contact tracing and inapparent infections.
Main Results:
- Approximately 70% of clinically diagnosed rubella cases were laboratory-confirmed.
- Clinical diagnosis accuracy ranged from 25-33% at the epidemic's start/end to 75-87% in the middle.
- Maculopapular rash and lymphadenopathy were key clinical signs, though lymphadenopathy was present in only 40% of cases.
- Inapparent rubella infection occurred in 5.14% of contact cases, independent of relationship closeness.
Conclusions:
- Clinical diagnosis of rubella during epidemics can be unreliable, highlighting the need for laboratory confirmation.
- Understanding transmission dynamics and inapparent infections is crucial for rubella control.
- Further research is required on pregnancy outcomes and congenital rubella infection following the epidemic.