Can Language Disorder Not Due To Peripheral Deafness Be An Isolated Expression Of Prenatal Rubella?

Rubella embryopathy may not be clinically evident at birth because of covert symptoms, progressive abnormality, or the normal delay in expression of certain functions, such as speech. In 1968, we treated a child with autism whose mother had rubella during the first trimester. The patient was not considered to have had the congenital rubella syndrome. Subsequently, others1,2 described autism, and other behavioral disorders in children with documented prenatal rubella infection. These observations led us to ask whether evidence for prenatal rubella could be obtained in a sample of autistic children, under the age of 6 years, without overt signs of this infection.

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Rubella Virus Infection, the Congenital Rubella Syndrome, and the Link to Autism

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193543 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3543 ◽

Cited By ~ 4

Author(s):

Anthony R. Mawson ◽

Ashley M. Croft

Keyword(s):

Virus Infection ◽

Vitamin A ◽

Liver Dysfunction ◽

Signs And Symptoms ◽

First Trimester ◽

Congenital Rubella Syndrome ◽

Hypervitaminosis A ◽

Background Rate ◽

Rubella Infection ◽

Congenital Rubella

Rubella is a systemic virus infection that is usually mild. It can, however, cause severe birth defects known as the congenital rubella syndrome (CRS) when infection occurs early in pregnancy. As many as 8%–13% of children with CRS developed autism during the rubella epidemic of the 1960s compared to the background rate of about 1 new case per 5000 children. Rubella infection and CRS are now rare in the U.S. and in Europe due to widespread vaccination. However, autism rates have risen dramatically in recent decades to about 3% of children today, with many cases appearing after a period of normal development (‘regressive autism’). Evidence is reviewed here suggesting that the signs and symptoms of rubella may be due to alterations in the hepatic metabolism of vitamin A (retinoids), precipitated by the acute phase of the infection. The infection causes mild liver dysfunction and the spillage of stored vitamin A compounds into the circulation, resulting in an endogenous form of hypervitaminosis A. Given that vitamin A is a known teratogen, it is suggested that rubella infection occurring in the early weeks of pregnancy causes CRS through maternal liver dysfunction and exposure of the developing fetus to excessive vitamin A. On this view, the multiple manifestations of CRS and associated autism represent endogenous forms of hypervitaminosis A. It is further proposed that regressive autism results primarily from post-natal influences of a liver-damaging nature and exposure to excess vitamin A, inducing CRS-like features as a function of vitamin A toxicity, but without the associated dysmorphogenesis. A number of environmental factors are discussed that may plausibly be candidates for this role, and suggestions are offered for testing the model. The model also suggests a number of measures that may be effective both in reducing the risk of fetal CRS in women who acquire rubella in their first trimester and in reversing or minimizing regressive autism among children in whom the diagnosis is suspected or confirmed.

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Serological evidence of acute rubella infection among under-fives in Mwanza: a threat to increasing rates of congenital rubella syndrome in Tanzania

Italian Journal of Pediatrics ◽

10.1186/s13052-016-0264-5 ◽

2016 ◽

Vol 42 (1) ◽

Cited By ~ 5

Author(s):

Mariam M. Mirambo ◽

Said Aboud ◽

Martha F. Mushi ◽

Mwanaisha Seugendo ◽

Mtebe Majigo ◽

...

Keyword(s):

Congenital Rubella Syndrome ◽

Serological Evidence ◽

Rubella Infection ◽

Congenital Rubella

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Prenatal diagnosis of congenital rubella infection in São Paulo

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.05.013 ◽

2014 ◽

Vol 60 (5) ◽

pp. 451-456

Author(s):

Suely Pires Curti ◽

Cristina Adelaide Figueiredo ◽

Maria Isabel de Oliveira ◽

Joelma Queiroz Andrade ◽

Marcelo Zugaib ◽

...

Keyword(s):

Amniotic Fluid ◽

Rubella Virus ◽

Fetal Death ◽

Congenital Rubella Syndrome ◽

Fetal Blood ◽

Rt Pcr ◽

Positive Serology ◽

Rubella Infection ◽

Molecular Assays ◽

Congenital Rubella

Objective: rubella during the early stages of pregnancy can lead to severe birth defects known as congenital rubella syndrome (CRS). Samples collected from pregnant women with symptoms and suspected of congenital rubella infection between 1996 and 2008 were analyzed. Methods: a total of 23 amniotic fluid samples, 16 fetal blood samples, 1 product of conception and 1 placenta were analyzed by serology and RT-PCR. Results: all patients presented positive serology for IgG / IgM antibodies to rubella virus. Among neonates, 16 were IgG-positive, 9 were IgM-positive and 4 were negative for both antibodies. Of the 25 samples analyzed in this study, 24 were positive by RT-PCR. Changes in ultrasound were found in 15 (60%) of 25 fetuses infected with rubella virus. Fetal death and miscarriage were reported in 10 (40%) of the 25 cases analyzed. The rubella virus was amplified by PCR in all fetuses with abnormal ultrasound compatible with rubella. Fetal death and abortion were reported in 10 of 25 cases analyzed. Conclusion: this study, based on primary maternal rubella infection definitely confirms the good sensitivity and specificity of RT-PCR using amniotic fluid and ultrasound. The results showed that molecular assays are important tools in the early diagnosis of rubella and congenital rubella syndrome.

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Congenital Rubella and Myxedema

PEDIATRICS ◽

10.1542/peds.69.4.495 ◽

1982 ◽

Vol 69 (4) ◽

pp. 495-496

Author(s):

Theodore W. AvRuskin ◽

Mario Brakin ◽

Christina Juan

Keyword(s):

Diabetes Mellitus ◽

Case Report ◽

Birth Weight ◽

First Trimester ◽

Congenital Rubella Syndrome ◽

Thyroid Disorders ◽

White Girl ◽

Congenital Rubella

Thyroid disorders have been reported following congenital rubella: four cases of thyroiditis1-4 and two patients with thyrotoxicosis5,6 are known. We report a patient with childhood myxedema and congenital rubella, and indicate that myxedema may occur as a sequela to rubella. This combination of disorders should be added to thyroiditis,5 hypopituitarism7 and adrenal insufficiency4 in the spectrum of possible late diabetes mellitus complications of the congenital rubella syndrome. Patients with congenital rubella should be tested periodically for these endocrine deficiencies. CASE REPORT An 8[unknown]-year-old white girl was the product of a seven-month gestation complicated by maternal rubella in the first trimester. Birth weight was 1 kg.

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Persistent Intraocular Rubella Infection in a Patient with Fuchs' Uveitis and Congenital Rubella Syndrome

Journal of Clinical Microbiology ◽

10.1128/jcm.03239-12 ◽

2013 ◽

Vol 51 (5) ◽

pp. 1622-1624 ◽

Cited By ~ 13

Author(s):

S. A. Winchester ◽

Z. Varga ◽

D. Parmar ◽

K. E. Brown

Keyword(s):

Congenital Rubella Syndrome ◽

Rubella Infection ◽

Congenital Rubella

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Preventing congenital rubella infection in the European Region of WHO: 2010 target

Eurosurveillance ◽

10.2807/esm.09.04.00455-en ◽

2004 ◽

Vol 9 (4) ◽

pp. 3-4 ◽

Cited By ~ 7

Author(s):

J. S. Spika ◽

F X Hanon ◽

S Wassilak ◽

R G Pebody ◽

N Emiroglu

Keyword(s):

Vaccine Coverage ◽

Policy Decision ◽

World Health Organisation ◽

Congenital Rubella Syndrome ◽

World Health ◽

Measles Vaccine ◽

Mmr Vaccine ◽

Regional Office ◽

Rubella Infection ◽

Congenital Rubella

The World Health Organisation (WHO) Regional Office for Europe has recently published a strategic plan and surveillance guidelines for measles and congenital rubella infection. The strategy prioritises measles control activities but encourages the introduction of rubella vaccine when measles vaccine coverage has reached >90 %; although, many western European countries with suboptimal measles vaccine coverage are already using the combined measles, mumps and rubella (MMR) vaccine. Women in these countries may have an especially high risk of having an infant with congenital rubella syndrome. WHO is seeking to improve the surveillance for rubella and congenital rubella syndrome as a means to obtain better information on the burden of these diseases and engage policy decision makers in the need to support the WHO European Region's strategies for rubella.

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Anti-Rubella IgM status in antenatal checkup visiting women

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v7i2.3010 ◽

1970 ◽

Vol 7 (2) ◽

pp. 76-79

Author(s):

KP KC ◽

S Malla ◽

P Ghimire ◽

SP Khanal ◽

SP Dumre

Keyword(s):

Pregnant Women ◽

Congenital Rubella Syndrome ◽

Serum Samples ◽

Rubella Vaccine ◽

Recent Infection ◽

Rubella Infection ◽

Congenital Rubella ◽

Health Research Council ◽

Adult Immunization ◽

Standard Operating Protocol

Background: Rubella is a viral infection. Congenital rubella syndrome is the most serious consequences of rubella which has been observed in pregnant women. This study has been done to reveal the association of rubella infection in women. Methods: The serum specimens were collected from women during their regular antenatal check up, in, was included in the study. Specimens were tested at NPHL every week following standard operating protocol of NPHL utilizing Human ELISA (German) kits and reagents. The results of the tests along with the clinical histories collected from the patient on a proforma file carried by the patients were analyzed following standard statistical tools. Results: During the three years study period, 320 serum samples were collected in 2006, 372 in 2007 and 400 in 2008, out of which 38 (11.87%), 72 (19.35%) and 49 (12.25%) of the women visiting NPHL during their antenatal checkup were found positive to anti-rubella IgM antibody respectively, indicating recent infection. Almost above 80% of the positive cases were from age group 20-30 years. Conclusions: The study showed the significant association of recent rubella infection in women which emphasizes requirement of adolescent or adult immunization with rubella vaccine at the earliest. Key words: anti-rubella IgM; congenital rubella syndrome; pregnant women; rubella. DOI: 10.3126/jnhrc.v7i2.3010 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 76-79

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Rubella Virus

10.1093/med/9780190604813.003.0013 ◽

2018 ◽

Author(s):

Emmaculate Lebo ◽

Susan Reef

Keyword(s):

Pregnant Women ◽

Rubella Virus ◽

Congenital Heart ◽

Heart Defects ◽

First Trimester ◽

Significant Progress ◽

Mental Impairment ◽

Rubella Infection ◽

Congenital Rubella ◽

Fetal Infection

Rubella infection in pregnant women, especially during the first trimester, can result in miscarriages, fetal deaths, stillbirths, or a constellation of congenital anomalies known as congenital rubella syndrome (CRS). Infants born with CRS often present with a myriad of classical symptoms, including hearing impairment, congenital heart defects, cataracts, and mental impairment. The risk of developing a congenital defect is highest when the rubella infection occurs during the first 12 weeks of gestation. The risks associated with fetal infection are primarily in pregnant women who are not immune to the rubella virus; immunity is acquired through vaccination with a rubella-containing vaccine or develops naturally following infection with rubella virus. In 2010, approximately 105,000 children with CRS were born globally, with an estimated 49,229 and 38,712 CRS cases born in the Southeast Asia and African WHO regions, respectively. Significant progress has been made toward reducing the burden of rubella and CRS cases globally through the introduction of rubella-containing vaccines in many countries.

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Rubella — what is the danger of this disease?

Spravočnik vrača obŝej praktiki (Journal of Family Medicine) ◽

10.33920/med-10-2102-02 ◽

2021 ◽

pp. 14-18

Author(s):

Vladimir Anatolievich Klimov

Keyword(s):

Clinical Symptoms ◽

Immunization Coverage ◽

Intrauterine Infection ◽

Joint Inflammation ◽

First Trimester ◽

Congenital Rubella Syndrome ◽

Developmental Defects ◽

Congenital Rubella ◽

Rubella Vaccination ◽

Torch Infections

Rubella, along with toxoplasmosis, cytomegalovirus and herpes, belongs to TORCH infections, diseases that can have a detrimental effect on the fetus if infected during pregnancy. The disease is caused by a virus, the only known source and carrier of which is human. Mostly children and young people are susceptible to the disease; they tolerate the disease quite easily. Of the clinical symptoms, it should be noted the appearance of a rash, a slight increase in temperature, regional lymphadenitis, and sometimes conjunctivitis. In adults, joint inflammation can also occur, which usually lasts 3–7 days. The rubella virus is most dangerous when a woman first becomes infected during pregnancy, especially in the first trimester. The probability of intrauterine infection of the fetus in this situation is 90 %, as a result of which it may die or develop congenital rubella syndrome (CRS). As a result, children with congenital rubella syndrome can suffer from developmental defects, hearing and visual impairments, diabetes mellitus and thyroid disorders. To prevent intrauterine infection of the fetus, vaccination against rubella is carried out, which leads to the development of stable immunity. Today rubella vaccination is carried out in 168 countries of the world, which allows immunization coverage of about 70 % of women. The countries of the African continent and Southeast Asia are the least affected by rubella vaccination, as a result of which there are about 4 cases of births of children in utero infected with the virus per 1000 births.

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