Congenital rubella

Definition

Congenital rubella is a condition that occurs in an infant whose mother is infected with the virus that causes German measles.

Causes

Congenital rubella occurs when the rubella virus in the mother affects the developing baby at a critical time, in the first 3 months of pregnancy. After the fourth month, the mother's rubella infection is less likely to harm the developing baby.

The number of babies born with congenital rubella has decreased dramatically since the introduction of the rubella vaccine.

Pregnant women who are not vaccinated for rubella and who have not had the disease in the past risk infecting themself and their unborn baby.

Symptoms

Symptoms in the infant may include:

• Cloudy corneas or white appearance to pupil
• Deafness
• Developmental delay
• Excessive sleepiness
• Irritability
• Low birth weight
• Mental retardation
• Seizures
• Small head size
• Skin rash at birth

Exams and Tests

The baby's health care provider will run blood and urine tests to check for the virus.

Treatment

There is no specific treatment for congenital rubella. Symptoms are treated as appropriate.

Outlook (Prognosis)

The outcome for a child with congenital rubella depends on the severity of problems present. Heart defects can often be corrected. Damage to the nervous system is permanent.

Possible Complications

Complications may involve many parts of the body.

Eyes:

• Cataracts
• Glaucoma
• Retinitis

Heart:

• Patent ductus arteriosus
• Pulmonary artery stenosis
• Other heart defects

Central nervous system:

• Mental retardation
• Motor retardation
• Small head from failed brain development
• Encephalitis
• Meningitis

Other:

• Deafness
• Low blood platelet count
• Enlarged liver and spleen
• Abnormal muscle tone
• Bone disease

When to Contact a Medical Professional

Call your health care provider if you have concerns about congenital rubella, if you are unsure of your vaccination status, or if you or your children need a rubella vaccine.

Prevention

Vaccination prior to pregnancy can prevent congenital rubella. Pregnant women who are not immune to rubella should avoid contact with persons who have carry the virus.

References

Mason WH. Rubella. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 244.

Edlich RF, Winters KL, Long WB 3rd, Gubler KD. Rubella and congenital rubella (German measles). J Long Term Eff Med Implants. 2005;15(3):319-328.

Bar-Oz B, Levichek Z, Moretti ME, Mah C, Andreou S, Koren G. Pregnancy outcome following rubella vaccination: a prospective controlled study. Am J Med Genet A. 2004;130(1):52-54.

Robertson SE, Featherstone DA, Gacic-Dobo M, Hersh BS. Rubella and congenital rubella syndrome: global update. Rev Panam Salud Publica. 2003;14(5):306-315.

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