Preparing for Elimination of Congenital Rubella Syndrome (CRS): Summary of a Workshop on CRS Elimination in the United States

Abstract

The goal of eliminating indigenous rubella and congenital rubella syndrome (CRS) in the United States in the near future is now within reach, because rubella incidence has been sustained at record-low levels since the mid-1990s. Effective prevention strategies to eliminate CRS and rubella require improvement in the surveillance of CRS and congenital rubella infection (CRI). The purpose of the workshop was to review rubella and CRS epidemiology, as well as current clinical, diagnostic, and laboratory practices, to determine whether new strategies are needed to achieve and document CRS elimination. Workshop participants agreed that surveillance for CRS must be strengthened, particularly through augmented laboratory capabilities, and the case definition for CRS must be revised to reflect the current scientific information available. Further studies of methods are needed to identify high-risk populations and geographic areas for rubella and CRS and to enhance identification of infants with CRS.

Epidemiological Characteristics of Rubella and Congenital Rubella Syndrome in the 2012–2013 Epidemics in Tokyo, Japan

“…Hearing impairment most frequently appears among the major complications of CRS, being observed in up to 96z of cases (3,13). However, the incidence of hearing impairment observed at diagnosis in this study, was as low as 25z.…”

Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana

“…2 Elimination goals have been set for Finland, the United States, and the English-speaking Caribbean, and rubella control in other regions of the Americas is a foreseeable goal. [3][4][5][6][7] The global picture is very different-only 28% of the developing countries routinely vaccinate against rubella. 8 Mathematic modeling has yielded congenital rubella syndrome disease burden estimates ranging from 110 000 to 308 000 per year.…”

Congenital Rubella Syndrome: A Case Report on Changes in Viral Load and Rubella Antibody Titers

“…1 CRI refers to all outcomes associated with intrauterine rubella infection, including miscarriage, stillbirth, a combination of birth defects, and asymptomatic infection. 2 Congenital rubella syndrome (CRS) refers to a CRI that occurs in various congenital defects (eg, deafness, cataract, and heart abnormalities). 2,3 Deafness is usually congenital, but a few cases of deafness after birth have been reported.…”

“…2 Congenital rubella syndrome (CRS) refers to a CRI that occurs in various congenital defects (eg, deafness, cataract, and heart abnormalities). 2,3 Deafness is usually congenital, but a few cases of deafness after birth have been reported. 3,4 Papania et al 5 reported in 2014 that since 2004 the incidence of rubella in the United States was <1 per 10 000 000 individuals and that the incidence of CRS was <1 per 5 000 000 births.…”