Journal
JOURNAL OF CLINICAL VIROLOGY
Volume 160, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.jcv.2022.105377
Keywords
Rubella; Rubella virus; Virus shedding; Viral load; RT-qPCR; Real-time RT-PCR; Virus isolation; Infection control
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This study analyzed samples from patients with rubella and found that virus shedding peaked 0-2 days after rash onset and decreased over time. The viral RNA load and presence of infectious rubella virus were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and virus isolation. These findings contribute to improved algorithms for rubella surveillance and diagnosis.
Background: Since the first isolation of rubella virus (RuV) in 1962, comprehensive data regarding the quanti-tative evaluation of RuV shedding remain unavailable. In this study, we evaluated the shedding of viral RNA and infectious virus in patients with acute RuV infection.Study design: We analyzed 767 specimens, including serum/plasma, peripheral blood mononuclear cells (PBMCs), throat swabs, and urine, obtained from 251 patients with rubella. The viral RNA load and presence of infectious RuV were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and virus isolation.Results: Virus excretion peaked 0-2 days after rash onset and decreased over time. The median viral RNA load dropped to an undetectable level on day 3 after rash onset in serum/plasma, day 2 in PBMCs, days 10-13 in throat swabs, and days 6-7 in urine. Infectious virus could be isolated for up to day 2 after rash onset in serum/ plasma, day 1 in PBMCs, days 8-9 in throat swabs, and days 4-5 in urine. The minimum viral RNA load that allowed virus isolation was 961 copies/mL in serum/plasma, 784 copies/mL in PBMCs, 650 copies/mL in throat swabs, and 304 copies/mL in urine. A higher viral RNA load indicated a higher likelihood of the presence of infectious virus.Conclusion: These findings would contribute to improve algorithms for rubella surveillance and diagnosis. In addition, this study indicates that the results of RT-qPCR enable efficient rubella control by estimating candidate patients excreting infectious virus, which could help prevent viral transmission at an early stage and eliminate rubella ultimately.
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