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Congenital rubella in the USSR
Insights
Congenital rubella poses a significant risk, with rubella virus causing intrauterine infections and birth defects in 73% of fetuses. Improved surveillance and prophylaxis for pregnant women are crucial in the USSR.
Area of Science:
- Virology
- Epidemiology
- Teratology
Background:
- Congenital rubella syndrome (CRS) is a major public health concern.
- Rubella virus infection during pregnancy can lead to severe fetal abnormalities.
- Understanding rubella epidemiology in the USSR is essential for prevention.
Purpose of the Study:
- To comprehensively study congenital rubella in Moscow and other USSR cities.
- To assess rubella incidence and seroprevalence in different age groups.
- To investigate the link between maternal rubella infection and congenital defects.
Main Methods:
- Serological screening for antihaemagglutinins in children and adults.
- Clinical and laboratory confirmation of rubella cases.
- Virological examination of fetuses and abortion materials.
- Serological investigation of mothers with children exhibiting congenital defects.
Main Results:
- Highest rubella incidence observed in children aged 1-7 years; adults also affected.
- High seroprevalence of antihaemagglutinins in adults (91-99%) and children (36-70%).
- Intrauterine viral infection confirmed in 73% of fetuses from infected mothers.
- 38% of infected fetuses displayed congenital defects; rubella virus confirmed as teratogenic.
Conclusions:
- Rubella virus strains in the USSR are teratogenic, causing significant congenital defects.
- There is a clear association between maternal rubella infection and CNS/cardiovascular defects.
- Enhanced rubella surveillance in pregnant women and prophylaxis strategies are urgently needed in the USSR.
Abstract:
The results of a comprehensive study of the problem of congenital rubella in Moscow and other cities of the USSR are presented. The highest rubella incidence was found among children 1-7 years of age; but 20-25 rubella cases were also recorded annually per 100 000 adults. Specific antihaemagglutinins were found in 36-70% of children and in 91-99% of adults. Investigation of the rubella foci revealed clinical rubella, confirmed by laboratory methods, in children and adults who had low initial titres of specific antihaemagglutinins. Serological screening of 1661 apparently healthy pregnant women detected antihaemagglutinins in 98.4%; however, low (1:8-1:16) titres were found in 53.3% and high (postinfection) titres and specific IgM in only 8.8% of cases.A study of 523 pregnant women who had been in contact with a source of infection revealed clinical rubella in 10.9% and inapparent infection in 0.7% of cases. A virological study of fetuses from infected pregnant women showed that there was intrauterine viral infection in 73% of cases; 38% of rubella-infected fetuses had congenital defects (unilateral or bilateral cataract, absence of one cerebral hemisphere, adhesion of the upper and lower eyelid, or diffuse damage of the crystalline lens); in one woman rubella virus was isolated from the fetuses and abortion materials received from two abortions with an interval of 6 months. Serological investigation of 519 mothers who had given birth to children with congenital defects showed that there were more frequent indications of rubella infection in the mothers of the children with CNS and cardiovascular defects, as well as in the children with congenital cardiovascular and CNS defects, than in the control groups. These data confirmed the teratogenic nature of rubella strains found in the USSR. This study indicates the need to improve rubella surveillance in pregnant women and to consider the prophylaxis of congenital rubella in the USSR. (See also Addendum.)