Rubella syndrome (congenital)

This is a condition that appears in the neonate as a result of rubella infection of the mother. The risk of developing CRS depends on the length of the pregnancy:

• in the first 8-10 weeks - fetal damage in up to 90% of infants and multiple defects are common (1)
• risk of fetal damage declines to 10-20% by 16 weeks (1)
• fetal damage as a result of maternal rubella infection is rare after 16 weeks gestation

The occurrence of the rash associated with rubella infection is a variable feature.

Often, rubella infection of the mother causes spontaneous abortion or causes serious damage to the surviving foetus - characterised by deafness, blindness and heart defects.

The viraemia may persist throughout pregnancy and the infant may continue to excrete virus for many years after birth. The disease process continues during the period of virus excretion.

Congenital rubella has been reported after cases of rubella re-infection during pregnancy. Rubella re-infection can occur in individuals with both natural and vaccine-induced antibody.

Reference:

• (1) The Green Book. Immunisation against infectious disease. Chapter 28 - Rubella. Public Health England 2013