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Revista Costarricense de Ciencias Médicas

Print version ISSN 0253-2948

Abstract

GONZALEZ, Luis  and  SAENZ, Elizabeth. Confirmación serológica de la rubéola en Costa Rica, 1998-1999. Rev. costarric. cienc. méd [online]. 2002, vol.23, n.1-2, pp.15-23. ISSN 0253-2948.

In this report, the experience of the National Reference Center at INCIENSA regarding the rubella outbreak reported in Costa Rica in 1998-1999 and the participation of the laboratory within the National Surveillance System is presentes. Following national and internacional guidelines of the Ministry of Health and the Pan-American Health Organization, rubella and congenital rubella syndrome (CRS) have been deciared national health priorities in Costa Rica and other American countries. The study inciuded a correlation of the epidemiological obligatory notification data available from the Epidemiological Surveillance Department of the Ministry of Health, with the laboratory resuits for all the samples referred from all over the country to the National Reference Center at lnciensa (CNDR). Data and samples were part of the actions of the National Eruptive Febrile Surveillance Program (EFEs) for the period between January 1st 1998 and December 31st 1999. Laboratory diagnostic confirmation was based on the detection of IgM anti- measles, rubella and dengue by immunoenzyme tests. Results showed that 40 % (n=623) of a total of 1559 cases notified to the Ministry of Health were confirmed by the laboratory. Fifty percent of the cases corresponded to the Central Southern Region, 24 % to the Central Northern Region and 26 to the rest of the country. Sixty percent of the affected population was between 15 an 44 years old but no significant difference was found by sex. Of the total of sampies sent to the CNDR, 25% (623/2504) showed to be positive by rubella serology. In 74% of the negative samples information regarding the days of evolution of the disease was not available or the sample was taken when the patient has 6 or less days of evolution. lntegrated surveillance of febrile diseases was able to detect 33% of the rubella positive samples that carne into the surveillance system with the presumptive diagnosis of febrile disease, measles and dengue, among others. Presumptive diagnosis was not indicated in 10 % out of the total samples sent to the CNDR. Of the samples received with a presumptive diagnosis of rubella, 2% showed to be positive by anti-rubella IgM antibodies. In conclusion, this report showed that the integrated participation of the laboratory within the National Surveillance System is a key supportive element for the epidemiological surveillance of rubella. The laboratory produces basic information for the timely making decision process within the National Health System by confirming the first suspicious cases and making a precise differential diagnosis with other diseases.

Keywords : rubella outbreak; congenital rubella syndrome; Febrile Surveillance Program.

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