Evaluation of rubella IgG antibodies among women at marriage in Kermanshah city, before and after mass vaccination

Rubella is a mild viral infectious disease, usually occurs subclinically without a serious complication. But if occurs during pregnancy, specially the first trimester, it can transmit and invade to fetus causing congenital rubella syndrome or fetal death. In 2003, nearly all Iranians at the age of 5 to 25 years old were vaccinated against rubella and the vaccine was included in the compulsory immunization, MMR afterwards. This study was carried out on girls attended at a marriage consultancy center in Kermanshah city [West of Iran] in 2006. Considering 95% of confidence, the sample size was estimated at 140. All samples were tested using ELISA serologic method and compared with similar study conducted on 240 unvaccinated girls at the same place in 1999. Antibody positivity was observed in 99.3%, compared to 79.58% of the previous study. A rise of 19.72% [95% CI 12.7%-26.7%] of seropositivity was observed in vaccinated girls versus unvaccinated ones [P < 0.001]. In our previous study, we had recommended to screen for susceptibility to rubella before marriage, which is no longer required since more than 99% of vaccinated girls showed immunity at the time of marriage. However, as sustainability of immunity after rubella vaccination is usually less than immunity due to illness, we recommend screening for rubella protective antibody every few years

first epidemic and new-emerging human fascioliasis in Kermanshah [western Iran] and a ten-year follow up, 1998-2008

Fascioliasis is one of the most common zoonotic diseases in Iran and other parts of the world. Although the largest epidemic of this disease has occurred in northern provinces of Iran [Guilan] during the past two decades and a few cases have also been reported in Tehran and the other provinces, there has been no evidence of its' occurrence in western provinces of Iran such as Kermanshah before the outbreak which is being reported. The study was conducted by teamwork of infectious disease specialist, parasitologist, general practitioner, entomologist, and laboratory technician. It is an "epidemic investigation" and a cross sectional descriptive one. Clinical data and para-clinical changes are recorded considering all of the population of a village in Kangavar, one of the suburbs of Kermanshah [western Iran]. The mean age was 21.65, [SD=12.44]. Fifty three percent were female, and all of them were farmers. Eighty two percent had a history of watercress ingestion in a period of 1-2 months before the admission and 18% consumed other vegetables. The average of eosinophils was 32.35% [SD=26]. The patients' Enzyme Linked Immunosorbent Assay [ELISA] and Counter Current Immuno-electrophoresis [CCIE] serological tests were reported positive by the department of parasitology, Pasteur Institute of Iran. Treatment response to triclabendazole was excellent. A ten-year clinical and laboratory follow-up revealed no evidence of abnormality in treated patients. It was the first case of human fascioliasis in west Iran and was a real epidemic and an emerging infectious disease for this area at that time. The clinical symptoms were less severe compared with other reports. Health education to inhabitants and health care workers can lead to rapid detection of such outbreaks

[Brucella spondylitis and paraspinal abscess]

Brucellosis is a zoonosis with a variety of clinical syndromes including spondylitis. Spondylitis and sacroiliitis are the most frequent complications of skeletal system involvement in brucellosis, but muscle infection and abscess formation are a rare complication and frequently secondary to spondylitis. In this article two cases of brucella spondylitis are presented which has led to abscess formation in one of them, these patients referred with back pain, fever, and with subsequeint MRI examination, wright positive test, were diagnosed as spondylitis. The antibiotic regiment including Doxycycline, Refampin, were prescripted for four months. The clinical signs were disapeared subsequently