Congenital rubella syndrome: Management, outcome, and prevention
- Simon R Dobson, MD, FRCP(C)
Simon R Dobson, MD, FRCP(C)
- Clinical Associate Professor, Division of Infectious and Immunological Diseases
- BC Children's Hospital
- Section Editors
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
- Leonard E Weisman, MD
Leonard E Weisman, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
The management, outcome, and prevention of congenital rubella syndrome (CRS) will be discussed here. The epidemiology of rubella infection, risk of rubella-associated congenital defects, and the clinical features and diagnosis of congenital rubella infection are discussed separately. (See "Rubella" and "Rubella in pregnancy" and "Congenital rubella syndrome: Clinical features and diagnosis".)
●Congenital rubella infection – Congenital rubella infection (CRI) encompasses all outcomes associated with intrauterine rubella infection (ie, miscarriage, stillbirth, combinations of birth defects, asymptomatic infection) .
●Congenital rubella syndrome – CRS refers to variable constellations of birth defects (eg, hearing impairment, congenital heart defects, cataracts/congenital glaucoma, pigmentary retinopathy, etc) (table 1) .
The clinical course of intrauterine rubella infection is not altered by treatment with antiviral or biologic agents [2-5], nor do these agents appear to have any long-term effect on the duration of viral shedding.
OVERVIEW OF MANAGEMENT
Supportive care and surveillance and are the cornerstones of management for CRS. Specific treatment depends upon the clinical manifestations, which may develop or progress over time (table 2). (See "Congenital rubella syndrome: Clinical features and diagnosis", section on 'Clinical features'.)
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- CLINICAL COURSE
- OVERVIEW OF MANAGEMENT
- SYMPTOMATIC MANAGEMENT
- Neonatal period
- Older infants and children
- LONG-TERM MONITORING
- Eye disease
- Cardiac disease
- Endocrine disease
- Immune deficiency
- Prevention of transmission
- - Child care
- - Hospitalized patients
- SUMMARY AND RECOMMENDATIONS