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Congenital rubella in Israel following the 1978-79 rubella epidemic
Insights
Congenital rubella syndrome (CRS) in infants can cause significant health issues, including deafness. This study identified 45 children with CRS, highlighting the impact of maternal rubella infection during pregnancy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Rubella infection during pregnancy can lead to congenital rubella syndrome (CRS).
- Recent rubella epidemics pose a risk for increased CRS cases.
- Early identification and management of CRS are crucial for affected children.
Purpose of the Study:
- To identify and characterize cases of congenital rubella syndrome (CRS) following a rubella epidemic.
- To determine the prevalence of major clinical defects and laboratory findings in children with CRS.
- To assess the gestational timing of maternal rubella infection and its correlation with infant defects.
Main Methods:
- Retrospective survey of children born with suspected CRS.
- Inclusion criteria: major clinical defects and positive laboratory findings for rubella (virus isolation, IgM, or HI antibodies).
- Data sources: hospital records, laboratory results, and active search in rehabilitation centers.
Main Results:
- 45 children were identified with CRS, 43 of whom had deafness.
- Other common defects included psychomotor retardation, microcephaly, cataracts, and heart defects.
- Maternal rubella infection, even up to the fifth month of gestation, resulted in significant infant abnormalities.
Conclusions:
- Congenital rubella syndrome (CRS) remains a significant concern following rubella outbreaks.
- Deafness is a primary manifestation, but a range of other severe defects can occur.
- Maternal rubella infection poses risks throughout early to mid-gestation, emphasizing the importance of vaccination.
Abstract:
We conducted a retrospective survey of children who were born with congenital rubella syndrome (CR) resulting from a recent rubella epidemic. Sources of information were hospital and laboratory records and data collected in an active search for deaf children born following the epidemic and attending rehabilitation centers for the deaf (Micha). Criteria for inclusion in the survey were: 1) major clinical defects, and 2) one or more of the following positive laboratory findings--virus isolation, presence of rubella-specific IgM antibodies, or the presence of hemagglutination inhibition (HI) antibodies in children beyond the age of 1 year. Excluded from the study were 28 children with persistent HI antibodies, but without clinically detected defects. CR was identified in 45, among them 43 with deafness. Other major defects were psychomotor retardation, microcephaly, cataracts and heart defects. Transient abnormalities included encephalitis, hepatosplenomegaly, jaundice, thrombocytopenia, intrauterine grown retardation and failure to thrive. Thirty-one mothers (70%) reported a history of clinical rubella in pregnancy, the others having experienced subclinical infection. Multiple defects were found in children born following early gestational rubella (less than 2 months); abnormalities also occurred as a consequence of rubella as late as the fifth month of gestation.