Rubella:

          Single-stranded RNA virus
          Vaccine-preventable disease
          No longer considered endemic in the U.S.
          Mild, self-limiting illness
          Infection earlier in pregnancy has a  higher probability of affected infant

Reported Rubella and CRS: US 1996 to 2002


Clinical Menifestation:

          Sensorineural hearing loss (50-75%)
          Cataracts and glaucoma (20-50%)
          Cardiac malformations (20-50%)
          Neurologic (10-20%)
          Others to include growth retardation, bone disease, HSM, thrombocytopenia, “blueberry muffin” lesions

Blueberry muffin” spots representing
extramedullary hematopoesis 

Diagnosis:

          Maternal IgG may represent immunization or past infection - Useless!
          Can isolate virus from nasal secretions
          Less frequently from throat, blood, urine, CSF
          Serologic testing
          IgM = recent postnatal or congenital infection
          Rising monthly IgG titers suggest congenital infection
          Diagnosis after 1 year of age difficult to establish

Treatment:

          Prevention…immunize, immunize, immunize!
          Supportive care only with parent education

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