Predicting congenital rubella syndrome in Japan, 2018-2019
Predicting congenital rubella syndrome in Japan, 2018-2019
复制标题
DOI：
10.1016/j.ijid.2019.02.021
复制
发表时间：
2019-05-01
影响因子：
8.4
通讯作者：
Nishiura, Hiroshi
中科院分区：
文献类型：
--
作者：
Lee, Hyojung;Kayano, Taishi;Nishiura, Hiroshi
目的：自2018年8月以来，风疹疫情一直在日本持续。本研究旨在预测2018- 2019年先天性风疹综合征（CRS）流行的可能规模。方法：根据成年女性风疹发病率、从感染胎龄到诊断CRS的时间延迟以及母亲分娩时的年龄分布，使用积分方程估计CRS病例的预期数量。我们使用2012-14年的流行病数据来参数化模型，并将其应用于2018- 19年的预测。结果：在分析2012-14年的流行病数据时，从母亲感染到诊断的平均延迟估计为24.2周（95%置信区间（CI）：20.7，28.1）。应用参数化模型，结合2018年480多例女性风疹病例以及2017年母亲分娩年龄延迟，我们确定CRS病例的预期数量为9.7例（95%CI：6.5，12.5）。如果到2018年第49周，成年女性风疹病例数增加到10倍，那么随着流行的持续，CRS病例数的累积可能达到96.8例（95%CI：65.3，125.5）。考虑到2019年第5周女性病例增加到650例，截至2019年第5周，2018-19年期间CRS病例的预期数量已经超过13例。(C)2019作者（S）由Elsevier Ltd代表国际传染病学会出版。
Objectives: A rubella epidemic has been ongoing in Japan since August 2018. In the present study, we aimed to predict the likely size of a congenital rubella syndrome (CRS) epidemic during 2018-19.Methods: The expected number of CRS cases was estimated using an integral equation based on age-specific incidence of rubella among adult women, the time delay from gestational age of infection to diagnosis of CRS, and distribution of the mothers' age at delivery. We used epidemic data during 2012-14 to parameterize the model and applied this in the prediction for 2018-19.Results: In analyzing the 2012-14 epidemic data, the mean delay from the mother's infection to diagnosis was estimated at 24.2 weeks (95% confidence interval (CI): 20.7, 28.1). Applying the parameterized model, together with the more than 480 rubella cases in women in 2018 as well as delayed mother's age at delivery in 2017, we determined that the expected number of CRS cases would be 9.7 (95% CI: 6.5, 12.5) cases. As the epidemic is ongoing, the cumulative number of CRS cases could potentially reach 96.8 (95% CI: 65.3, 125.5) cases, if rubella cases in adult women rose to 10 times the number by week 49 in 2018.Conclusions: CRS is expected to occur an average of 24 weeks following the mother's infection with rubella virus. Accounting for an increase to 650 cases in women by week 5 in 2019, the expected number of CRS cases during 2018-19 has already exceeded 13 cases, as of week 5 in 2019. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.