Do streptococci cause toxic shock?
Authors: J A McGlashan
Journal: BMJ (1990)

Congenital rubella in the Asian community in Britain SIR, -We have previously reported that suscepti- bility to rubella was nearly threefold higher in Asian than in non-Asian pregnant women screened during 1984, and that this was associated with a 2 3-fold excess of congenital rubella among babies born to Asian women compared with those born to non-Asian women.'In recent years the Department of Health, the Health Education Authority, and charitable organisations such as the National Rubella Council have tried to promote rubella immunisation in the Asian communities in Britain.We repeated our earlier survey to assess the response to these campaigns.Data on rubella susceptibility according to age, parity, and ethnic group were obtained for pregnant women screened by Leeds, Luton, and Manchester public health laboratories between July 1988 and June 1989.Of the 3946 Asian women identified, 133 (3 4%) were susceptible compared with 808 (1-2%) of 68252 non-Asian women (p<00001).The percentages of Asian and non-Asian pregnant women found to be susceptible by the same three laboratories during 1984 were 6 1% and 2 2% respectively.Although rubella susceptibility has declined in both ethnic groups over the past four to five years, a threefold difference between Asian and non-Asian women remains.Differences in susceptibility were apparent in all age and parity groups (table ).The greater susceptibility to rubella among Asian women is reflected in the number of cases of laboratory confirmed rubella infection in pregnancy reported to the Communicable Disease Surveillance Centre.Between July 1988 and June 1989 a total of 86 cases were reported, of which 10 (12%) were in Asian women.This is disproportionately high in relation to the per- centage of births among Asian women in England and Wales: 7-3% during 1988.2The number of Asian babies provisionally reported to the National Congenital Rubella Surveillance Programme continues to be disproportionately high, with 10 of the 60 babies born with this condition during 1987-9 being Asian.Clearly, the promotion of selective rubella vaccination in the Asian community needs to be continued.Identifying women who have immigrated to Britain after the age at which rubella vaccination is offered at school is particularly important as these women probably account for the higher rubella susceptibility in the Asian group.For example, of the 20 nulliparous Asian women aged under 20 years identified as susceptible by the three laboratories during 1988-9, 13 were recent immigrants; only four were known to have attended school in England and missed or refused rubella vaccine (no information was obtained for three of the women).Although the measles, Susceptibility to rubella among Asian and non-Asian pregnant women according to parity and age* Women aged -19 Women aged 20-29 Women aged ¢30 No (%) with No (%) with No (%) with No tested negative test result No tested negative test result No tested negative test result Nulliparous women: Asian 263 20(7-6) 699 49(7-0) 138 7(5 1) Non-Asian 5 424 76(1-4) 15 815 269(1-7) 3 417 77(2-2) Parous women: Asian 72 2(2-8) 1 471 32(2-2) 1 034 11(1 1) Non-Asian 1 242 11 (0-9) 17 538 79 (0 5) 8 945 52 (0-6) *Table excludes 282 Asian women whose age or parity was not known, of whom 12 (4 2%) had negative test results, and 16 999 non-Asian women, of whom 266 (1-6%) had negative test results.