Clinical Studies of Patients with Rubella Syndrome Occurring in a High Incidence in the Ryukyu Islands in 1965: On the Diagnostic Significance of Clinical Manifestations

Abstract

The 620 cases with a history of maternal rubella and/or with one or more of cataract, CHD and deafness born in the Ryukyu Islands in 1965 were subjected to clinical studies and 360 cases were diagnosed as rubella syndrome. Rubella retinopathy makes a reliable diagnostic basis for rubella syndrome. As for the typical combination of clinical manifestations, the cases with cataract have CHD, deafness and retinopathy; the cases with CHD not accompanied by cataract have deafness and retinopathy; and the cases with deafness not accompanied by cataract and CHD either have or have not retinopathy. The cases with cataract alone or with CHD can extremely rarely be denned as having rubella syndrome. There existed the close relationship between the combination of clinical manifestations and the time of maternal rubella infection. The main clinical manifestations of rubella syndrome are cataract, congenital heart disease (CHD), and deafness appearing singly or two or more together1)2). Etiology of the congenital cataract, CHD, or deafness is mostly not explained; and only a small portion of the incidence is due to intrauterine rubella infection. For the future of the patients in the above conditions and for their parents, clarification as to whether they are or are not due to rubella is very important. Current general practice for the diagnosis of rubella syndrome is laboratory diagnosis that measures rubella hemagglutination inhibition (HI) antibodies3)4). As the infants grows in age, the above mentioned technique may not assure an absolute judgment5)6). This makes it necessary to arrive at diagnosis from the clinical findings. A prompt, direct diagnosis from the clinical findings alone will be very convenient. In the Ryukyu Islands where there was a high incidence of rubella syndrome in infants in the second half of 1965, we analyzed clinical findings of the affected children with cataract, CHD or deafness on the basis of serological diagnosis. The diagnostic significance of the clinical findings was so studied. Hence our report in this paper.

Seven‐Year Follow‐Up Study of Rubella Syndrome in Ryukyu with Special Reference to Persistence of Rubella Hemagglutination Inhibition Antibodies

“…"The cases were classified on the basis of clinical manifesta tions into the following four groups, i. e., cataract group (cataract with congenital heart disease, deafness and/or retinopathy), congenital heart disease (CHD) group (CHD with deafness and/or retinopathy), deafness-1 group (deafness with retinopathy) and deaf ness-2 group (deafness without other clinical manifestations). The diagnosis depended on pediatric examinations, audiometry and oph thalmologic examinations [8]. Each case was examined two to seven times.…”

“…After a rubella epidemic occurring in the Ryukyu Islands in 1965 more than 450 children with rubella syndrome were born [8]. Four hundred and eight cases have so far been registered by the Congenital Rubella Study Group of Kyushu University.…”