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

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