Congenital rubella syndrome: progress and future challenges

Abstract

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 implemented around the world to achieve effective preventive strategies. In Costa Rica, vaccination against rubella started in 1972 and in 1986, the combined measles, mumps and rubella vaccine was introduced in the national schedule among 1-year-old children. This vaccination strategy shifted the susceptibility to other groups at child-bearing age. To protect this age group, in 2001 Costa Rica implemented a successful national immunization campaign targeting both men and women aged 15-39 years, followed by postpartum vaccination of women who were pregnant when the campaign was implemented. The epidemiological surveillance system of rubella and CRS cases was strengthened and it was integrated with the investigation and notification system of febrile eruptive diseases. We describe the Costa Rican experience, which has led to similar actions in other countries in Latin America. Challenges and strategies in the elimination of rubella and CRS are also discussed.

Structured models of infectious disease: Inference with discrete data

“…2d). The signature of this has been documented in the burden of CRS (Morice et al, 2009). The pattern closely matches the cohorts unprotected by vaccination through time (Fig.…”

“…Theoretical concerns about increases in the CRS incidence following introduction of rubella vaccination (Knox, 1980) appear to have been to some degree born out in the country (Morice et al, 2009). Vaccination was introduced at first at low coverage levels, and following years of low incidence, large outbreaks in older individuals occurred in 1987 and 1999.…”

Seroprevalence of rubella virus IgG in pregnant women in Harare, Zimbabwe

“…1 In pregnant women, primary infection with the virus may cause congenital rubella syndrome (CRS), often accompanied by miscarriage, stillbirth and/or birth defects in infants. 2,3 It is therefore strongly recommended by the World Health Organization that serological surveys on rubella virus infection in women of childbearing age be done.…”

Characterizing Viral Exanthems

“…Arthralgias and arthritis are also common. The most serious complication of rubella is congential rubella syndrome, which classically presents with the triad of deafness, cataracts and cardiac disease [11]. The differential diagnosis includes other maculopapular exanthems, such as measles, roseola, parvovirus B-19 infection and drug eruptions.…”