Rubella Infection In Pregnant Woman and Its Transmission to Baby Signs Diagnosis Treatment Prevention

    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 Manifestation:

•          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 hematopoiesis 

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