Does Rubella Cause Autism: A 2015 Reappraisal?

Abstract

In the 1970s, Stella Chess found a high prevalence of autism in children with congenital rubella syndrome (CRS), 200 times that of the general population at the time. Many researchers quote this fact to add proof to the current theory that maternal infection with immune system activation in pregnancy leads to autism in the offspring. This rubella and autism association is presented with the notion that rubella has been eliminated in today’s world. CRS cases are no longer typically seen; yet, autistic children often share findings of CRS including deafness, congenital heart defects, and to a lesser extent visual changes. Autistic children commonly have hyperactivity and spasticity, as do CRS children. Both autistic and CRS individuals may develop type 1 diabetes as young adults. Neuropathology of CRS infants may reveal cerebral vasculitis with narrowed lumens and cerebral necrosis. Neuroradiological findings of children with CRS show calcifications, periventricular leukomalacia, and dilated perivascular spaces. Neuroradiology of autism has also demonstrated hyperintensities, leukomalacia, and prominent perivascular spaces. PET studies of autistic individuals exhibit decreased perfusion to areas of the brain similarly affected by rubella. In both autism and CRS, certain changes in the brain have implicated the immune system. Several children with autism lack antibodies to rubella, as do children with CRS. These numerous similarities increase the probability of an association between rubella virus and autism. Rubella and autism cross many ethnicities in many countries. Contrary to current belief, rubella has not been eradicated and globally affects up to 5% of pregnant women. Susceptibility continues as vaccines are not given worldwide and are not fully protective. Rubella might still cause autism, even in vaccinated populations.

The Role of the Immune System in Autism Spectrum Disorder

“…that the connection persists and offered several reasons for why the rubella-autism connection might be difficult to work out (eg, widespread vaccination, rubella may evade the fetal immune system, children with CRS often lack antibodies to rubella, etc) as well as some ideas for future research, such as using cord blood or prescreening newborns before rubella vaccination (Hutton, 2016).…”

From Viral Infections to Autistic Neurodevelopmental Disorders via Cross-Reactivity

“…We selected and analyzed five proteomes belonging to infectious agents that have been reported as related to or concomitant with ASD. That is, BDV [38][39][40] , RUBV [41][42][43][44][45][46] , MeV [41,47,48] , Influenza A virus [49][50][51] , MuV [41] . As a control, we used Parvovirus B19.…”

“…We pursued the hypothesis that peptide commonality between microbial and human proteins might have the potential to trigger cross-reactions in the human host during infection, thus inducing autoimmune pathologic sequelae [30][31][32][33][34][35][36][37] . Here, we test such a hypothesis by analyzing viral pathogens that have been related to ASD [38][39][40][41][42][43][44][45][46][47][48][49][50][51] -namely Borna disease virus, Rubella virus, Measles virus, Influenza A virus, and Mumps virus-and searching for amino acid (aa) sequences common to (i) human proteins that, when altered, have been associated with autistic disorders, and (ii) proteins expressed by Y-linked genes.…”

Rubella (German measles) revisited

“…25 Delayed manifestations, in addition to sensorineural hearing impairment, include mental retardation, psychomotor retardation, speech delay, attention deficit hyperactivity syndrome, autism, behavioural disorders, progressive encephalopathy, insulin-dependent diabetes mellitus, thyroid dysfunction (hypothyroidism, hyperthyroidism, thyroiditis), Addison disease, growth hormone deficiency, and immunological defects. 4,5,25,[36][37][38]…”