Congenital rubella

Background

Pathophysiology

• Transplacental transfer of rubella virus occurs during viremia, which peaks about 5 to 7 days following infection of mother
  • Mother may be asymptomatic

Clinical Presentation

• Spectrum of disease, which includes intra-uterine fetal demise, preterm delivery, and the congenital rubella syndrome
• Severity depends in part on timing of infection
  • Infection in first trimester has 80% chance of defects
  • Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
  • Intra-uterine growth restriction is likely only effect in third trimester
• Most children are asymptomatic at birth, but can develop signs and symptoms after several years
• Deafness, cataracts, glaucoma, congenital heart disease, and cognitive defects
• Low birth weight, thrombocytopenic purpura, hepatosplenomegaly, meningoencephalitis, retinopathy, patent ductus arteriosus, pulmonary stenosis, developmental disorders, cryptorchidism, inguinal hernia
• By the second decade of life, it can cause a progressing, fatal panencephalitis