Congenital rubella syndrome is prevented by ensuring that everyone in the eu is vaccinated against rubella. Congenital rubella syndrome world health organization. Although rubella virus infection usually causes a mild febrile rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome crs. It was discovered in 1941 by australian ophthalmologist norman mcalister gregg. The role of rubellaimmunoblot and rubellapeptideeia for the diagnosis of the congenital rubella syndrome during the prenatal and newborn periods.
Depending on the gestational period when the mother contracts rubella, an infant born with crs may be unaffected by the virus or it may have severe developmental defects. Congenital rubella syndrome is caused by a virus known as a rubivirus. Incomplete rubella vaccination programmes result in continued disease transmission. Rubella can cause congenital rubella syndrome in the newborn, the most severe sequela of rubella. The rubella epidemic of 19631965 resulted in 1,800,000 infected individuals, approximately 20,000 fetal deaths and about 30,000 infants born with congenital rubella syndrome. Rubella is characterized by a mild, maculopapular rash. Rania tohmecdc more than 100,000 children worldwide are born with congenital rubella syndrome crs every year to mothers infected with the rubella virus. Overview 2, 3, 5, 7 rubella is a viral illness caused by a togavirus of the genus rubivirus and may be prevented through vaccination. Only one antigenic type of rubella virus is available, and humans are the only natural hosts. Neurodevelopmental disorders as a group defined as combining asd. Rubella is a leading cause of vaccinepreventable birth defects. Rubella is a virus that usually causes a mild illness in children or adults.
Persistence of rubellaspecific igg in the infant after 6 to 12 mo suggests congenital infection. Dec 11, 2018 the rubella epidemic of 19631965 resulted in 1,800,000 infected individuals, approximately 20,000 fetal deaths and about 30,000 infants born with congenital rubella syndrome. Yyes nno uunknown division of infectious disease epidemiology rev09. Congenital rubella is a viral infection acquired from the mother during pregnancy. Rubella syndrome, or congenital rubella, is a group of physical abnormalities that have developed in an infant as a result of maternal infection and subsequent fetal infection with rubella virus.
When pregnant women get infected with rubella virus, their babies also are exposed, which may result in serious complications. The epidemiology of rubella infection, risk of rubella associated congenital defects, and the clinical features and diagnosis of congenital rubella infection are discussed separately. The congenital rubella syndrome crs is an important cause of blindness, deaf ness, congenital heart disease, and mental retardation. Congenital heart disease especially pulmonary artery stenosis and patent ductus arteriosus 50% of patients. The epidemiology of rubella infection, risk of rubellaassociated congenital defects, and the clinical features and diagnosis of congenital rubella infection are discussed separately. If a pregnant woman contracts rubella during her first trimester, there is a very good chance that she will pass it on to her fetus. Cases of congenital rubella syndrome crs may be prevented as follows. Control of rubella and congenital rubella syndrome crs in.
Disease factsheet about congenital rubella syndrome crs. Congenital rubella is a syndrome that occurs when a fetus has been infected with the rubella virus while in the uterus. The results have been merged in this way to present. The congenital rubella syndrome project final report sense. Congenital rubella refers to the group of birth defects that occur in an. Recent developments on the measles and rubella immunization. There were nine cases of rubella in england and wales in 2014. It may also cause prematurity, low birth weight, and neonatal thrombocytopenia, anemia and hepatitis. Rubella is now a very uncommon infection in the uk as a result of the vaccination programme. Crs cases are classified by year of patients birth. Congenital rubella syndrome crs is an illness in infants that results from maternal infection with rubella virus during pregnancy. Progress toward rubella and congenital rubella syndrome.
Rubella and congenital rubella syndrome are caused by rubella virus. Crs is characterized by any of a number of complications and findings, including blindness, heart defects, deafness, behavioral disorders. In approximately 20% of the cases, rubella infections result in the death of the foetus. Congenital rubella syndrome what is congenital rubella syndrome. Definition of congenital rubella syndrome medicinenet. When rubella infection occurs during early pregnancy, serious consequencessuch as miscarriages, stillbirths, and sever birth defects can result. Syndromes are conditions which consist of a range of symptoms found together. Sep 07, 2018 the rubella epidemic of 19631965 resulted in 1,800,000 infected individuals, approximately 20,000 fetal deaths and about 30,000 infants born with congenital rubella syndrome. However, rubella is still common in many developing countries. The role of rubella immunoblot and rubella peptideeia for the diagnosis of the congenital rubella syndrome during the prenatal and newborn periods.
The congenital rubella syndrome case report worksheet appendix 17 pdf icon 2 pages is used to collect clinical and laboratory information on cases of crs that are reported by jurisdiction and local health departments. A congenital disorder is a health condition which exists at the time a baby is born. Rubella, congenital syndrome crs 1990 case definition recommend on facebook tweet share compartir note. In particular, women who are planning to get pregnant should be vaccinated as this protects the mother as well as the foetus. Infants suspected of having congenital rubella syndrome should have antibody titers and specimens obtained for viral detection. Congenital rubella syndrome crs is the major complication associated with rubella infections. Congenital rubella occurs when the rubella virus in the mother affects the developing baby in the first 3 months of pregnancy. Pdf questionmy 22yearold patient immigrated to canada 6 years ago from.
Oct 29, 2015 signs and symptoms the classic triad for congenital rubella syndrome is. Congenital rubella syndrome crs is an illness that can occur in infants as a result from maternal infection with the rubella virus during pregnancy. The babys mental and physical development also may be abnormal, and diseases such as diabetes may develop later in life. Control of rubella and congenital rubella syndrome crs. The constellation of abnormalities caused by infection with the rubella german measles virus before birth. Congenital rubella is rare in developed countries but is still a risk among nonimmunized pregnant women in the developing world.
It is primarily characterized by abnormalities of the heart and nervous system, the eyes and the ears. O nce a main cause of congenital abnormalities 1, congenital rubella syndrome crs is now rare in the united. They include cardiac and ocular lesions, deafness, microcephaly, mental retardation, and generalized growth retardation. Congenital rubella syndrome crs the embryo project. The molecular basis for the causation of congenital rubella syndrome are not yet. Measles infection of the mother during the first trimester of pregnancy is associated with encephalitis, hearing loss, and blindness in the newborn infant, and, later, intellectual disabilities. Congenital rubella syndrome crs can occur in a developing fetus of a pregnant woman who has contracted rubella german measles, usually in the first trimester. When rubella infection occurs during early pregnancy, serious consequences such as miscarriages, stillbirths, and a constellation of severe birth defects in infants can result. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. The molecular basis for the causation of congenital rubella syndrome are not yet completely clear, but in vitro studies. The elimination of rubella and congenital rubella syndrome in the united states has been a great vaccination success story.
The virus is spherical with a diameter of 5070 nm, has a central core ie, nucleocapsid, and is covered externally by a lipidcontaining envelope. Surveillance manual congenital rubella syndrome vpds. Congenital rubella syndrome definition of congenital. Signs are multiple congenital anomalies that can result in fetal death. It is characterized by rash at birth, low birth weight, small head size, heart abnormalities, visual problems and bulging fontanelle. Congenital rubella syndrome crs is an illness in an infant due to rubella virus infection in the mother during pregnancy.
Congenital rubella syndrome cases will be classified epidemiologically as internationally imported or u. Gamma globulin probably has no part in the treatment of rubella in mother or child. Rubella, and subsequently congenital rubella syndrome crs, is a vaccine preventable disease. Pdf development of congenital rubella syndrome associated with rubella virus infection during pregnancy is clinically important, but the pathogenicity. When adults and children contract the disease, it is known as rubella, or german measles. Congenital rubella syndrome in child of woman without. Congenital rubella syndrome crs can occur in children whose mothers contract the rubella virus, sometimes called german measles, during pregnancy. In 1998, standard case definitions for surveillance of crs and rubella. If such an infection does not lead to miscarriage or still birth, the neonate may show severe congenital malformations. National uptake of antenatal screening for rubella susceptibility fell slightly from 98. The management, outcome, and prevention of congenital rubella syndrome crs will be discussed here.
Sep 15, 2017 congenital rubella refers to the group of birth defects that occur in an infant whose mother is infected with the virus that causes german measles rubella during pregnancy. Congenital rubella genetic and rare diseases information. Rubella, congenital nord national organization for rare. Aug 08, 2019 rubella syndrome, or congenital rubella, is a group of physical abnormalities that have developed in an infant as a result of maternal infection and subsequent fetal infection with rubella virus. The rubella virus vaccine, licensed in 1969 and adopted widely in the united states by the early 1980s, led to a dramatic reduction in acquired rubella virus infection and congenital rubella syndrome. Possible signs and symptoms of crs include deafness and heart and eye defects. The defects associated with congenital rubella syndrome crs most commonly affect the eyes e. Transplacental infection of the fetus with rubella usually in the first trimester of pregnancy, as a consequence of maternal infection, resulting in various developmental abnormalities in the newborn infant. If the infection occurs 012 weeks after conception, the risk increases to 81%. Detection of rubellaspecific igm antibodies generally also indicates rubella infection, but falsepositive igm results can occur. Congenital rubella syndrome an overview sciencedirect topics. May 06, 2020 since 1941, when gregg first described the triad of deafness, cataracts and cardiac disease as the classical clinical manifestations of congenital rubella syndrome crs, strong efforts have been. When pregnant women are infected with rubella virus, their babies also are exposed, which may result in serious complications. Global progress in rubella and congenital rubella syndrome crs control and elimination activities world health organization who regions, 2000 and 2012 who region 2000.
Since 1941, when gregg first described the triad of deafness, cataracts and cardiac disease as the classical clinical manifestations of congenital rubella syndrome crs, strong efforts have been. Global progress in rubella and congenital rubella syndrome crs control and elimination activities world health organization who. Sensorineural deafness 58% of patients eye abnormalities especially retinopathy, cataract and microphthalmia 43% of patients. Feb 09, 2017 rubella and congenital rubella syndrome are caused by rubella virus. Congenital rubella syndrome refers to the entirety of symptoms shown by a child whose mother contracted rubella during early pregnancy.
Rubella and congenital rubella syndrome control and elimination global progress, 20002012. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 20. Sadly, these children will suffer a lifetime because of birth defects such as blindness, deafness, and heart disease, even though a costeffective vaccine is widely available. Although rubella and congenital rubella syndrome have been eliminated from the united states, clinicians should remain vigilant and immediately notify public health authorities when either is suspected. Since early 2000 no cases of congenital rubella syndrome have resulted from infections acquired in the united states cdc, 2005, 2017b. During epidemic years, congenital rubella infection was found using serologic testing to identify nonsymptomatic cases in as many as 2% of newborns. If infection occurs 028 days before conception, the infant has a 43% risk of being affected. Congenital rubella syndrome crs can occur in a developing fetus of a pregnant woman who has contracted rubella, usually in the first trimester. Rubella in fection of the fetus can result in fetal death or in the birth of an infant with serious congenital birth defects. Apr 06, 2020 there have been fewer babies with congenital rubella syndrome following the introduction of the measles, mumps and rubella mmr vaccine, as the number of cases of rubella has fallen. Congenital rubella syndrome is a group of physical abnormalities that have developed in an infant as a result of maternal infection and subsequent fetal infection with rubella virus. Rubella remains an important pathogen worldwide, with many cases of congenital rubella syndrome per year. Rubella, congenital syndrome florida department of health. Disease description congenital rubella syndrome crs is an illness in infants that results from maternal infection with rubella virus during pregnancy.
Rubella and congenital rubella syndrome new jersey. Jan 27, 2015 rubella is now a very uncommon infection in the uk as a result of the vaccination programme. Measles elimination and rubellacongenital rubella syndrome control 5 the discussion includes. Rubella virus infection, the congenital rubella syndrome. Rubella and congenital rubella syndrome verywell family. About europe pmc funders joining europe pmc governance roadmap outreach tools. Signs and symptoms the classic triad for congenital rubella syndrome is. The syndrome crs follows intrauterine infection by the rubella virus and comprises cardiac, cerebral, ophthalmic and auditory defects. Before the development of rubella virus vaccine, epidemics of rubella and congenital rubella occurred about every six to nine years.
Congenital rubella syndrome crs is an illness in an infant caused by rubella virus infection in the mother during pregnancy. Pdf pathogenesis of congenital rubella virus infection in human. Of the six cases of congenital rubella syndrome reported between 2004 and 2011, at least five of the cases involved pregnant mothers who were infected with rubella outside. Crs risk is unrelated to severity of symptoms in the mother.
Surveillance guidelines for measles, rubella and congenital rubella syndrome in the who european region update december 2012 introduction 6 assess and document progress towards elimination, providing information for verification of measles and rubella elimination. Monguarodriguez n, diazortega jl, garciagarcia l, pinapozas m, ferreiraguerrero e, delgadosanchez g, ferreyrareyes l, cruzhervert lp, baezsaldana r, campos. Congenital rubella syndrome an overview sciencedirect. Congenital rubella syndrome is an underrecognized public health problem in bangladesh and the burden of the disease weighs heavily on patients and society. Lateonset manifestations of congenital rubella syndrome are diabetes, thyroid dysfunction, and visual or neurological abnormalities. Since the introduction of the rubella vaccine in 1969 there are less than 120 cases of congenital rubella syndrome reported each year. Worldwide, it is estimated that there are more than 100. Up to 90% of infants born to mothers infected in the first trimester will develop the physical anomalies referred to as congenital rubella syndrome crs. Congenital rubella syndrome, or crs, is a disorder that affects a baby in the womb when the mother is infected with the rubella virus. Congenital rubella pediatrics merck manuals professional. The syndrome is characterized by multiple congenital malformations birth defects and mental retardation the individual features of the syndrome include growth retardation, microcephaly abnormally small head, cataracts. They include cardiac and ocular lesions, deafness, microcephaly, mental retardation, and. A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance.