{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:29:20Z","timestamp":1762918160202,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Rubella, also known as German measles or three-day measles, is an infectious disease caused by virus of the genus Rubivirus, which may be prevented by vaccination. The infection is potentially dangerous for non immune subjects, although 20\u201350% of infected subjects are asymptomatic. Healthcare workers (HCWs) have an increased potential exposure to rubella in comparison to the general population, putting them and their patients at risk of infection and its complications. In 2019, 20 cases of rubella have been reported in Italy. According to the Italian National Immunization and Prevention Plan, HCWs should provide a written certification of vaccination for rubella or serological evidence of protective antibodies. The aim of the study was to evaluate the rubella immunization status in female HCWs of the teaching hospital Policlinic Rome Tor Vergata (PTV) of childbearing age. For this purpose, we retrospectively checked the serologic values of rubella-specific IgG antibodies analyzing the clinical records of the HCWs of undergoing the occupational health surveillance program from January 1st to June1st 2020. Five hundred fourteen HCWs with a mean age of 23.19 (range 19\u201337, DS: 2.80) were included: 90.3% (464) showed a protective antibody titre. The mean value of the anti-rubella IgG was 49.59 IU\/mL. Our study shows a non-protective anti rubella IgG titre in a substantial percentage of HCWs (9.7%). As vaccine protection decreases over the years and the risk of congenital rubella syndrome (CRS) in vaccinated subjects should not be underestimated, we suggest routine screening of the immunological status followed by the administration of a third dose of vaccine if the antibody titre becomes non-protective.<\/jats:p>","DOI":"10.3390\/ijerph17217992","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T09:29:32Z","timestamp":1604050172000},"page":"7992","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Rubella Immunity among Italian Female Healthcare Workers: A Serological Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2470-6107","authenticated-orcid":false,"given":"Luca","family":"Coppeta","sequence":"first","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2292-3338","authenticated-orcid":false,"given":"Cristiana","family":"Ferrari","sequence":"additional","affiliation":[{"name":"School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Iannuzzi","sequence":"additional","affiliation":[{"name":"School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iacopo","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavia","family":"Balbi","sequence":"additional","affiliation":[{"name":"School of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Pietroiusti","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2327-1455","authenticated-orcid":false,"given":"Marco","family":"Trabucco Aurilio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (CDC) (2017, September 15). Rubella (German Measles, Three-Days Measles); Sign and Symptoms, Available online: https:\/\/www.cdc.gov\/rubella\/index.html."},{"key":"ref_2","unstructured":"Long, S.S., Pickering, L.K., and Prober, C.G. (2008). Rubella Virus. Principles and Practice of Pediatric Infectious Diseases, Churchill Livingstone Elsevier. [3rd ed.]."},{"key":"ref_3","unstructured":"Shukla, S., and Maraqa, N.F. (2020). Congenital Rubella, StatPearls Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s40659-019-0254-3","article-title":"Molecular aspects of the teratogenesis of rubella virus","volume":"52","author":"George","year":"2019","journal-title":"Biol. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1017\/S0022172400063452","article-title":"Fetal infection resulting from maternal rubella after the first trimester of pregnancy","volume":"85","author":"Ridehalgh","year":"1980","journal-title":"J. Hyg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/S0140-6736(82)92677-0","article-title":"Consequences of confirmed maternal rubella at successive stages of pregnancy","volume":"2","author":"Miller","year":"1982","journal-title":"Lancet"},{"key":"ref_7","unstructured":"Giambi, C., Del Manso, M., Bella, A., Filia, A., and Rota, M.C. (2018, March 01). Rosolia Congenita e in Gravidanza News. Available online: http:\/\/www.epicentro.iss.it\/problemi\/rosolia\/bollettino.asp."},{"key":"ref_8","unstructured":"Jankovic, D. (2012). Rubella and CRS overview for WHO Europe, Progress Toward Rubella Elimination and CRS Prevention in Europe."},{"key":"ref_9","unstructured":"Filia, A., Bella, A., Del Manso, M., Baggieri, M., Marchi, A., Bucci, P., Magurano, F., Nicoletti, L., and Rota, M.C. (2019, October 01). Morbillo & Rosolia News, N. 56. Available online: https:\/\/www.epicentro.iss.it\/morbillo\/bollettino\/RM_News_2019_56.pdf."},{"key":"ref_10","unstructured":"Filia, A., Bella, A., Del Manso, M., Baggieri, M., Marchi, A., Bucci, P., Magurano, F., Nicoletti, L., and Rota, M.C. (2020, January 01). Morbillo & Rosolia News. Available online: https:\/\/www.epicentro.iss.it\/morbillo\/bollettino\/RM_News_2019_58.pdf."},{"key":"ref_11","unstructured":"Centers for Disease Control and Prevention (CDC) (2013). Rubella and congenital rubella syndrome control and elimination\u2014global progress, 2012. Wkly. Epidemiol. Rec., 88, 521\u2013532. Available online: https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6248a3.htm."},{"key":"ref_12","unstructured":"Centers for Disease Control and Prevention (CDC) (2005). Progress toward elimination of measles and prevention of congenital rubella infection\u2014European region, 1990\u20132004. MMWR Morb. Mortal. Wkly. Rep., 54, 175\u2013178."},{"key":"ref_13","unstructured":"Centers for Disease Control and Prevention (CDC) (2013). Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 62, 1\u201334."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"855","DOI":"10.15585\/mmwr.mm6839a5","article-title":"Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination\u2014Worldwide, 2000\u20132018","volume":"68","author":"Grant","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_15","unstructured":"Filia, A., Bella, A., Manso, M., and Rota, C. (2014, April 01). Istituto Superior di Sanit\u00e0. Morbillo. Aspetti Epidemiologici. Available online: http:\/\/www.epicentro.iss.it\/problemi\/morbillo\/epidItalia.asp."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1080\/23744235.2020.1739746","article-title":"Susceptibility to measles among healthcare workers: A cross-sectional serological study","volume":"52","author":"Coppeta","year":"2020","journal-title":"Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.jhin.2018.11.022","article-title":"Workplace vaccination against measles in a teaching hospital of Rome","volume":"101","author":"Coppeta","year":"2019","journal-title":"J. Hosp. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Coppeta, L., Biondi, G., Lieto, P., and Pietroiusti, A. (2019). Evaluation of Immunity to Measles in a Cohort of Medical Students in Rome, Italy. Vaccines, 7.","DOI":"10.3390\/vaccines7040214"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/23744235.2020.1772498","article-title":"Persistence of antibodies for measles among vaccinated medical students in Italy","volume":"52","author":"Coppeta","year":"2020","journal-title":"Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/occmed\/kqy132","article-title":"Measles immunity in an Italian teaching hospital","volume":"69","author":"Coppeta","year":"2019","journal-title":"Occup. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.coviro.2019.01.002","article-title":"Successes and challenges for preventing measles, mumps and rubella by vaccination","volume":"34","author":"Bankamp","year":"2019","journal-title":"Curr. Opin. Virol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3876","DOI":"10.1016\/j.vaccine.2019.05.049","article-title":"Seroprevalence and durability of rubella virus antibodies in a highly immunized population","volume":"37","author":"Crooke","year":"2019","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/21645515.2015.1093263","article-title":"Primary vaccine failure to routine vaccines: Why and what to do?","volume":"12","author":"Wiedermann","year":"2016","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_24","unstructured":"(2011, November 25). Centers for Disease Control and Prevention (CDC) Immunization of Health-Care Personnel Recommendations of the Advisory Committee on Immunization Practices (ACIP) Recommendations and Reports\/Vol. 60\/No. 7, Available online: https:\/\/www.cdc.gov\/mmwr\/pdf\/rr\/rr6007.pdf."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/ajcp\/106.2.170","article-title":"Rubella Immunity Defining the Level of Protective Antibody","volume":"106","author":"Laurence","year":"1996","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_26","first-page":"E98","article-title":"Strategies for elimination of rubella in pregnancy and of congenital rubella syndrome in high and upper-middle income countries","volume":"61","author":"Terracciano","year":"2020","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1080\/21645515.2019.1688041","article-title":"Elimination of congenital rubella: A seroprevalence study of pregnant women and women of childbearing age in Italy","volume":"16","author":"Marchi","year":"2020","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1080\/21645515.2018.1564442","article-title":"Pre-vaccination IgG screening for mumps is the most cost-effectiveness immunization strategy among Health Care Workers","volume":"15","author":"Coppeta","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Coppeta, L., Pompei, A., Balbi, O., Zordo, L.M., Mormone, F., Policardo, S., Lieto, P., Pietroiusti, A., and Magrini, A. (2019). Persistence of Immunity for Hepatitis B Virus among Healthcare Workers and Italian Medical Students 20 Years after Vaccination. Int. J. Environ. 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