Congenital Rubella Syndrome Definition

Congenital Rubella Syndrome
Definition:

Congenital rubella syndrome (CRS) is an illness resulting from rubella virus infection during pregnancy. It is more likely if a susceptible pregnant woman is infected in the first trimester of gestation.

Signs and symptoms:

Severe birth defects in infants can result from the infection. Common congenital defects include cataracts, congenital heart disease, deafness, and developmental delay. Hearing impairment is the most common single defect. CRS symptoms may be delayed from 2 to 4 years.

Transmission:

Rubella is spread by droplets from the respiratory secretions of infected persons. It may be transmitted by subclinical cases or those without symptoms. Infants with CRS may shed the virus for 12 months.

Diagnosis:

Lab tests such as rubella virus isolation and positive antibody tests are the most reliable methods of diagnosing CRS. Moderate or severe CRS is usually recognizable at birth, but mild illness may not be detected for months or even years after birth.

Role of the School Nurse:

Prevention

• 
  Educate staff and parents on immunization requirements for school entry and attendance
  
• 
  Monitor for onset of rash in unimmunized or nonimmune students
  
• 
  Refer pregnant staff and students to their provider for determination of immunity to rubella
  

Treatment Recommendations

There is no treatment for this viral syndrome.

Exclusions

• 
  Infants with CRS should be excluded from school daycare for 12 months, or until two negative viral cultures have been documented after the infant is at least 3 months old
  
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  Persons having contact with infants with CRS should have documented evidence of immunity to rubella
  
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  Caregivers of infants with CRS should be aware of potential hazard to susceptible pregnant contacts
  
• 
  Education modifications may be warranted in children diagnosed with CRS
  

Reporting Requirements

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  Congenital rubella syndrome is a reportable disease. Call Maine CDC at 1-800-821-5821 or fax report to 1-800-293-7534
  

Resources:

• 
  Maine CDC rubella website, including fact sheet http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vaccine/rubella.shtml
  
• 
  Federal CDC website http://www.cdc.gov/vaccines/pubs/surv-manual/chpt15-crs.html
  

Created 3/14/2016