Congenital rubella syndrome

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Congenital rubella syndrome
Cataracts due to Congenital Rubella Syndrome (CRS) PHIL 4284 lores.jpg
White pupils due to congenital cataracts in a child with congenital rubella syndrome

Congenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant woman who has contracted rubella, usually in the first trimester. If infection occurs 0–28 days before conception, the infant has a 43% risk of being affected. If the infection occurs 0–12 weeks after conception, the risk increases to 81%. If the infection occurs 13–26 weeks after conception, the risk is 54% of the infant being affected by the disease. Infants are not generally affected if rubella is contracted during the third trimester, or 26–40 weeks after conception. Problems rarely occur when rubella is contracted by the mother after 20 weeks of gestation and continues to disseminate the virus after birth.

It was discovered in 1941 by Australian Norman McAlister Gregg.[1]

Signs and symptoms

The classic triad for congenital rubella syndrome is:[2]

Other manifestations of CRS may include:

Children who have been exposed to rubella in the womb should also be watched closely as they age for any indication of:


The cause of Congenital rubella syndrome occurs when the virus infects the placenta and hence fetus. [10]


Congenital rubella serology time-line

The diagnosis of this condition is done via molecular analysis done on amniotic fluid and by positive Rubella specific IgM after birth[10]

Differential diagnosis

The DDx is established via the following:[10]

  • Enteroviruses
  • CMV
  • Herpes simplex virus
  • Varicella
  • Syphilis
  • Toxoplasma gondii


Vaccinating the majority of the population is effective at preventing congenital rubella syndrome.[11] For women who plan to become pregnant, the MMR (measles mumps, rubella) vaccination is highly recommended, at least 28 days prior to conception.[4] The vaccine should not be given to women who are already pregnant as it contains live viral particles.[4]

Other preventative actions can include the screening and vaccinations of high-risk personnel, such as medical and child care professions.[12]


There is no current treatment for this condition[10]


  1. Atkinson, William (2011). Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Public Health Foundation. pp. 301–323. ISBN 9780983263135. Archived from the original on 1 May 2017. Retrieved 30 March 2015.
  2. "Congenital rubella syndrome | Sense". Archived from the original on 2015-09-27. Retrieved 2015-07-30.
  3. Oster ME, Riehle-Colarusso T, Correa A (January 2010). "An update on cardiovascular malformations in congenital rubella syndrome". Birth Defects Research Part A: Clinical and Molecular Teratology. 88 (1): 1–8. doi:10.1002/bdra.20621. PMID 19697432. Archived from the original on 2021-10-06. Retrieved 2021-07-11.
  4. 4.0 4.1 4.2 4.3 4.4 "Congenital Rubella Symptoms & Causes | Boston Children's Hospital". Archived from the original on 2019-03-06. Retrieved 2019-03-05.
  5. Muhle, R; Trentacoste, SV; Rapin, I (May 2004). "The genetics of autism". Pediatrics. 113 (5): e472–86. doi:10.1542/peds.113.5.e472. PMID 15121991. Archived from the original on 2021-05-06. Retrieved 2021-07-11.
  6. Brown, A. S (9 February 2006). "Prenatal Infection as a Risk Factor for Schizophrenia". Schizophrenia Bulletin. 32 (2): 200–202. doi:10.1093/schbul/sbj052. PMC 2632220. PMID 16469941.
  7. Naeye, Richard L. (1965-12-20). "Pathogenesis of congenital rubella". JAMA. 194 (12): 1277–1283. doi:10.1001/jama.1965.03090250011002. ISSN 0098-7484. PMID 5898080.
  8. Forrest, Jill M.; Menser, Margaret A.; Burgess, J. A. (1971-08-14). "High Frequency of Diabetes Mellitus in Young Adults with Congenital Rubella". The Lancet. 298 (7720): 332–334. doi:10.1016/S0140-6736(71)90057-2. PMID 4105044.
  9. Sudharshan S, Ganesh SK, Biswas J (2010). "Current approach in the diagnosis and management of posterior uveitis". Indian J Ophthalmol. 58 (1): 29–43. doi:10.4103/0301-4738.58470. ISSN 0301-4738. PMC 2841371. PMID 20029144.
  10. 10.0 10.1 10.2 10.3 RESERVED, INSERM US14-- ALL RIGHTS. "Orphanet: Congenital rubella syndrome". Archived from the original on 20 January 2021. Retrieved 27 October 2021.
  11. "Rubella vaccines: WHO position paper" (PDF). Wkly Epidemiol Rec. 86 (29): 301–16. 15 July 2011. PMID 21766537. Archived (PDF) from the original on 4 April 2018. Retrieved 11 July 2021.
  12. "Congenital Rubella - Pediatrics". Merck Manuals Professional Edition. Archived from the original on 2019-03-06. Retrieved 2019-03-05.
External resources