Rubella, also known as german measles, is an acute viral illness characterized by mild constitutional symptoms, a rash similar to that of mild rubeola or scarlet fever, and enlargement and tenderness of the postoccipital, retroauricular, and posterior cervical lymph nodes. The congenital rubella syndrome case report worksheet appendix 17 cdcpdf 2 pages is used to collect clinical and laboratory information on cases of crs that are reported by state and local health departments. Feb 09, 2017 a median of 11 rubella cases was reported in the united states range. Crs cases are classified by year of patients birth. In addition, as many as 50% of rubella infections may be subclinical. Discussed are clinical manifestations, potential fetal damage, and prevention of congenital rubella. 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 was discovered in the 1940s, rubella virus was isolated in the early 1960s, and rubella vaccines became available by the end of the same decade. If infection occurs 028 days before conception, the infant has a 43% risk of being affected. Rubella infection in the first trimester of pregnancy can lead to fetal death, premature delivery, and serious birth defects. The measles, mumps and rubella mmr vaccine offers safe and effective protection against rubella and is the main vaccine in use in europe.
The number of babies born with this condition is much smaller since the rubella vaccine was developed. A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Rubella remains an important pathogen worldwide, with roughly 100 000 cases of congenital rubella syndrome estimated to occur every year. Rubella virus rv is an enveloped, positivesense, singlestranded rna virus of the genus rubivirus, the family togaviridae. The clinical features can be transient, selflimiting, or permanent, and some features may not manifest until adolescence or adulthood called late. Rubella is a viral illness that causes a mild fever and a skin rash. An infant with at least one of the symptoms clinically consistent with congenital rubella syndrome listed above, and laboratory evidence of congenital rubella infection demonstrated by. Twentyeight 42% of the 67 rubella cases reported from 2005 through 2011 were known importations. This report discusses the accomplishments of the rubella vaccination program in costa rica and the challenges posed by rubella and congenital rubella syndrome in the future. Congenital rubella syndrome is caused by a virus known as a rubivirus. Laboratory criteria for diagnosis isolation of rubella virus, or demonstration of rubellaspecific igm antibody, or an infants rubella antibody level that persists above and beyond that expected form. 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. The most important consequence of rubella infection is congenital rubella syndrome, which may result from infection during pregnancy. Rubella is also known as german measles and is caused by rubella virus.
Crs is clinically confirmed in an infant if a qualified physician detects at least two of the following complications. Rubella, congenital nord national organization for rare. The role of rubellaimmunoblot and rubellapeptideeia for the diagnosis of the congenital rubella syndrome during the prenatal and newborn periods. Congenital rubella syndrome definition of congenital. Congenital rubella syndrome an overview sciencedirect topics.
Rubella meaning in the cambridge english dictionary. All positive laboratory results for rubella virus are reportable to the public health surveillance unit by secure fax 2049483044. Congenital rubella syndrome is rare in the developed countries, however it is still a a. Congenital rubella syndrome crs the embryo project. Viral infections including varicella, measels, rubella, hepatitis a and b, influenza. Approach to the patient with neutropenia in childhood. Therefore, 2 doses of a mmrvaccine are recommended for all. History of rubella and rubella vaccination leading to. Rubella and congenital rubella syndrome in pediatric new page 2. Rubella is spread through contact with fluid from the nose and throat. Congenital rubella syndrome cases will be classified epidemiologically as internationally imported or u. Rubella is a systemic virus infection that is usually mild.
However, rubella is still common in many developing countries. The presence of any defects or laboratory data consistent with congenital rubella infection as reported by a health professional. The monitoring report is based on measles and rubella data from the european surveillance system tessy for 1 june 2018 to 31 may 2019. Pdf rubella is a major public health problem which is usually a mild rash illness in children and adults. The laboratory diagnosis of rubella can be made either though serologic testing or by viral culture. Progress in rubella and congenital rubella syndrome. Retinopathy, microphthalmia small eye, cataract, glaucoma, corneal opacification, or uveitis, present in over 70% of cases. The prevalence of crs in the prevaccine period can be estimated by evaluating the proportion of children in the population with sensorineural hearing loss attributable to rubella. Rubella infection is related to the hemophagocytic syndrome. Rubella is characterized by a mild, maculopapular rash. Abstract rubella is a mild illness that presents with fever and rash.
Congenital rubella occurs when the rubella virus in the mother affects the developing baby in the first 3 months of pregnancy. Disease description rubella is a viral illness caused by a togavirus of the genus rubivirus and is characterized by a mild, maculopapular rash. See the immunisation handbook ministry of health 2011 for further information. 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. Rubella, caused by the rubella virus, is a disease characterized by mild fever and a rash that starts on the face and spreads to the rest of the body. Rubella chapter 4 2020 yellow book travelers health. Incomplete rubella vaccination programmes result in continued disease transmission, as. The symptoms of rubella are rather like a mild cold, starting with a slight fever, sore throat. Serum igm antibodies may be present in an infant with congenital rubella syndrome for up to a year after birth. Rubella, congenital syndrome florida department of health. Before the development of rubella virus vaccine, epidemics of rubella and congenital rubella occurred about every six to nine years.
Although rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially. Rubella in children health encyclopedia university of. Treatment of symptomatic infection is largely supportive, as the illness is selflimited. 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. This is a highly infectious disease and the patient can pass the disease to other persons from 1 week before to 1 week after onset of rash. Singleantigen rubella vaccine is not available in new zealand. Rubella also known as german measles is a viral infection spread by direct contact with an infected person or droplet spread from respiratory secretions it is preventable by vaccine. Congenital rubella syndrome crs is an important cause of severe birth defects. Rubella, acute page 1 rubella, acute or postnatal german measles, 3day measles see also rubella, congenital syndrome 1. Rubella definition rubella is a highly contagious viral disease, spread through contact with discharges from the nose and throat of an infected person.
A person with rubella may spread the disease to others from 1 week before the rash begins, until 1 to 2 weeks after the rash disappears. Surveillance for crs complements rubella surveillance. Congenital rubella syndrome crs can be prevented with appropriate vaccination programs. Surveillance guidelines for measles, rubella and congenital rubella syndrome in the who european region update december 2012 introduction 5 information needs of an immunization programme, and that it supports effective programme management. Congenital rubella syndrome is a group of physical abnormalities that have developed in an infant as a. Rubella vaccines are reported to be approximately 97% effective in preventing disease after a single dose. Rubella definition of rubella by medical dictionary. Congenital rubella syndrome rubella is an acute viral disease often affecting susceptible children and young adults worldwide. Congenital rubella syndrome crs can occur in a developing fetus of a pregnant woman who has contracted rubella, usually in the first trimester. In approximately 20% of the cases, rubella infections result in the death of the foetus. A child is most contagious when the rash is appearing.
In particular, women who are planning to get pregnant should be vaccinated as this protects the mother as well as the foetus. During the period of maternal viremia, rv may infect the placenta, pass the placental barrier and enter the fetal bloodstream. Between 1964 and 1965, there was a worldwide epidemic of rubella, also known as german measles. Wanita usia subur bisa menjalani pemeriksaan serologi untuk rubella. Vaksin rubella merupakan bagian dari imunisasi rutin pada masa kanakkanak. Yyes nno uunknown division of infectious disease epidemiology rev09. Systematic vaccination against rubella, usually in combination with measles, has eliminated both the congenital and acquired infection from some developed countries.
There were nine cases of rubella in england and wales in 2014. A clinical diagnosis of rubella may be difficult to make because many exanthematic diseases may mimic rubella infection. Congenital rubella syndrome oklahoma state department of health. Rubella and congenital rubella syndrome in the philippines. It is characterized by rash at birth, low birth weight, small head size, heart abnormalities, visual problems and bulging fontanelle. Rubela wikipedia bahasa indonesia, ensiklopedia bebas. 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.
This disease is often mild with half of people not realizing that they are infected. Congenital rubella syndrome crs is the major complication associated with rubella infections. Congenital rubella syndrome crs is an illness in infants that results from. The immune response may involve more than humoral immunity, but it is clear that. The serologic diagnosis consists of demonstrating the presence of rubellaspecific immunoglobulin m igm antibody in a single serum sample or observation of a significant 4fold rise in rubellaspecific immunoglobulin g igg antibody titer between the. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 20. Global progress toward rubella and congenital rubella. The epidemiology of rubella infection is discussed separately. Rubella is caused by a virus that is spread through the air or by close contact. It can, however, cause severe birth defects known as the congenital rubella syndrome crs when infection occurs early in pregnancy.
The main concern with rubella virus infection, however, is the effect it can have on an pregnant woman. As of april 2014, all countries in the eueea recommend that all people should be vaccinated against rubella. The prevalence rates of rubella and crs in iran are unknown. Disease factsheet about congenital rubella syndrome crs. Number of rubella cases by month and notification rate per. During pregnancy immunity to rubella is checked routinely. Unpublished studies n 4 on congenital rubella syndrome. Rubella and congenital rubella syndrome new jersey. If the infection occurs 012 weeks after conception, the risk increases to 81%.
Specialty consultation is strongly recommended for pregnant women with ex. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. As a physician, emphasizing the safety of the mmr vaccine to patients is important. Immunolocalization and distribution of rubella antigen in. The frequency of congenital rubella thus depends upon the number of women of childbearing age who are susceptible to the virus, and the frequency of rubella infection in the community. Those with a rubella antibody level below 15 iuml should be counselled to avoid contact with cases of rubella while pregnant, and should be offered mmr vaccination after delivery.
Probable clinical cases of rubella are reportable to the public health surveillance unit by telephone 2047886736 during regular hours 8. Congenital rubella syndrome congenital rubella syndrome crs refers to variable constellations of birth defects eg, hearing impairment, congenital heart defects, cataractscongenital glaucoma, pigmentary retinopathy, etc. Since the introduction of the rubella vaccine in 1969 there are less than 120 cases of congenital rubella syndrome reported each year. It starts with a low fever, runny nose, and diarrhea. Most cases of rubella infection are mild and resolve spontaneously within a week. Infection of fetus exposed to maternal rubella during first trimester of pregnancy. Additionally, there were two rubella outbreaks reported involving three cases, as well as four total crs cases. Rubella notifications and laboratoryconfirmed cases by year, 19972015. Rubella has symptoms that are similar to those of flu. 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. Petechiae on the soft palate of the same individual forchheimers sign. Congenital rubella syndrome crs can occur in children whose mothers contract the rubella virus, sometimes called german measles, during pregnancy. However, the public health importance of rubella relates to the teratogenic effects when rubella infection is acquired in the early months of pregnancy.
It usually starts on the face and spreads to the rest of the body. Clear explanations of natural written and spoken english. Rubellacontaining vaccine is highly effective and safe and, as a result, endemic rubella transmission has been interrupted in the americas since 2009. Then a rash appears on the face, and spreads down the body. Commonly a mild acute febrile disease frequently demonstrating an erythematous maculopapular rash and few constitutional symptoms, which may. In 2012, mmr vaccine was recommended for women who are planning pregnancy or for those who have had a baby to protect them from rubella. Congenital rubella syndrome crs is an illness in an infant due to rubella virus infection in the mother during pregnancy. Vaksin mmr diberikan pada usia 1215 bulan, dosis kedua diberikan pada usia 46 tahun. Rubella, congenital syndrome crs 1990 case definition recommend on facebook tweet share compartir note. Mutations in the neutrophil elastase gene are responsible of this syndrome. National uptake of antenatal screening for rubella susceptibility fell slightly from 98. Pregnant women who contracted rubella in the first trimester of their pregnancy could pass the rubella virus to their developing fetus, causing the child to be born deaf, blind, with cardiac problems, developmental delays and other medical conditions. When pregnant women are infected with rubella virus, their babies also are exposed, which may result in serious complications. Although rubella causes only mild symptoms of low fever, swollen glands, joint pain, and a fine red rash in most children and adults, it can have severe complications for women in their first trimester.
Congenital rubella syndrome crs is an illness in an infant caused by rubella virus infection in the mother during pregnancy. When a woman is infected with the rubella virus early in pregnancy, she has a 90% chance of passing the virus on to her fetus. Rubella virus infection, the congenital rubella syndrome. Congenital rubella syndrome is a reportable disease in oklahoma. We report a case of congenital rubella syndrome in a child born to a vaccinated new jersey woman who had not traveled internationally. Congenital rubella syndrome crs is the term used to describe the group of congenital abnormalities that occur in a child as a result of rubella infection of mother during gestation. Jika tidak memiliki antibodi, diberikan imunisasi dan baru boleh hamil 3 bulan setelah penyuntikan. Congenital rubella is caused by the harmful action of the rubella virus on the fetus at an important time in growth. The trip database provides clinical publications about evidence.
The rubella rash occurs in 50%80% of rubellainfected persons and is sometimes. Psychiatric manifestations of congenital rubella syndrome. 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. If a mother is not immune to rubella mmr vaccine is recommended. Congenital rubella syndrome world health organization. The majority of infections occur in children and young adults. Rubella and the congenital rubella syndrome crs have largely been eliminated in the united states. When pregnant women get infected with rubella virus, their babies also are exposed, which may result in serious complications.
Progress in rubella and congenital rubella syndrome control and. However, the public health importance of rubella relates to the teratogenic effects when rubella infection is acquired in the. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Crs is characterized by any of a number of complications and findings, including blindness, heart defects, deafness, behavioral disorders. Jun 21, 2005 numerous cases of congenital rubella syndrome due to rubella reinfection have been reported. Monthly measles and rubella monitoring report, july 2019 en pdf 3. Congenital rubella syndrome what is congenital rubella syndrome. It can be transmitted by contact with secretions from nose and throat of infected persons through droplet spread or direct contact with patients. A rash may start around two weeks after exposure and last for three days. Although rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or infants with a constellation of congenital malformations known as congenital rubella syndrome crs. Rubella, congenital rubella syndrome, surveillance, immunization programs. Congenital rubella syndrome in child of woman without known.
Prevention and control measures for congenital rubella. Because the measlesmumpsrubella mmr vaccine is given to most children, rubella is much less common now. Congenital rubella syndrome crs is a serious disease caused by rv infection in utero plotkin et al. After the fourth month, if the mother has a rubella infection, it is less likely to harm the developing baby. Jan 27, 2015 rubella is now a very uncommon infection in the uk as a result of the vaccination programme. When rubella infection occurs during early pregnancy, serious consequencessuch as miscarriages, stillbirths, and sever birth defects can result. Lateonset manifestations of congenital rubella syndrome are diabetes, thyroid dysfunction, and visual or neurological abnormalities.
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. When adults and children contract the disease, it is known as rubella, or german measles. Apr 08, 2020 congenital rubella syndrome is prevented by ensuring that everyone in the eu is vaccinated against rubella. Rubella is a viral illness caused by a togavirus of the genus rubivirus and may be prevented through vaccination. Rubella is a highly contagious infectious disease, which can lead to malformations during pregnancy or even death of the child in the womb. Public health and primary health care communicable. Congenital rubella syndrome despite maternal antibodies. Surveillance manual congenital rubella syndrome vpds.
However, the primary symptom of rubella virus infection is the appearance of a rash exanthem on the face which spreads to the trunk and limbs and usually fades after three days that is why it is often referred to as threeday measles. Congenital rubella syndrome crs is an illness that can occur in infants as a result from maternal infection with the rubella virus during pregnancy. Congenital rubella syndrome in iran bmc infectious diseases. During epidemic years, congenital rubella infection was found using serologic testing to identify nonsymptomatic cases in as many as 2% of newborns. Pregnant women infected with rubella virus run the risk of harmful effects to their growing fetus. Rubella and congenital rubella syndrome page 1 of 15. Thus, infants younger than 1 month and with symptoms consistent with congenital rubella syndrome should be retested at 1 month of age. Rubella and congenital rubella syndrome crs description. Rubella, also known as german measles or threeday measles, is an infection caused by the rubella virus. Congenital rubella syndrome an overview sciencedirect. The rash is sometimes itchy and is not as bright as. As many as 8%% of children with crs developed autism during the rubella epidemic of the 1960s compared to the background rate of about 1 new case per 5000 children. Although it causes only a mild clinical illness in these groups, its public health importance is due to the teratogenic potential of the virus resulting in congenital rubella syndrome crs.