Congenital rubella syndrome CDC case definitions: Difference between revisions

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{{CMG}} {{AE}} {{KD}}
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{{Congenital rubella syndrome}}
{{Congenital rubella syndrome}}
==Overview==
In 2009, the [[CDC]] published the case classification of congenital rubella syndrome and divided into suspected cases, probable cases, confirmed cases and infection only, based on symptoms and/or laboratory findings.<ref name="CDC"> Center for Disease Control and Prevention https://www.cdc.gov/vaccines/pubs/surv-manual/chpt15-crs.html. Accessed on Jan 5, 2017 </ref>


==CDC Case Definitions==
==CDC Case Definitions==
===Suspected Case===
in 2009, the [[CDC]] published the following case definition for case classification of congenital rubella syndrome:<ref name="CDC"> Center for Disease Control and Prevention https://www.cdc.gov/vaccines/pubs/surv-manual/chpt15-crs.html. Accessed on Jan 5, 2017 </ref>
An infant who does not meet the criteria for a probable or confirmed case but who has one or more of the following findings:
*[[Cataract]]s
*Congenital [[glaucoma]]
*[[Congenital heart disease]] (most commonly [[patent ductus arteriosus]] or peripheral [[pulmonary artery stenosis]])
*[[Hearing impairment]]
*Pigmentary [[retinopathy]]
*[[Purpura]]
*[[Hepatosplenomegaly]]
*[[Jaundice]]
*[[Microcephaly]]
*[[Developmental delay]]
*[[Meningoencephalitis]] or
*Radiolucent bone disease


===Probable Case===
{| class="wikitable"
An infant who does not have laboratory confirmation of rubella infection but has at least two of the following, without a more plausible etiology:
!Case Classification
*[[Cataract]]s or congenital [[glaucoma]],
!Criteria
*[[Congenital heart disease]] (most commonly patent ductus arteriosus or peripheral pulmonary artery stenosis),
|-
*[[Hearing impairment]]
!Suspected
*Pigmentary [[retinopathy]]
|An [[infant]] who does not meet the criteria for a probable or confirmed case but who has '''one or more''' of the following findings:
* [[Cataracts]]
* [[Congenital]] [[glaucoma]]
* [[Congenital heart disease]] (most commonly [[patent ductus arteriosus]] or peripheral [[pulmonary artery stenosis]])
* [[Hearing impairment]]
* Pigmentary [[retinopathy]]
* [[Purpura]]
* [[Hepatosplenomegaly]] ([[HSM]])
* [[Jaundice]]
* [[Microcephaly]]
* [[Developmental delay]]
* [[Meningoencephalitis]], or
* Radiolucent [[bone disease]]
|-
!Probable
|An [[infant]] who '''does not have laboratory confirmation of [[rubella]]''' infection but has '''at least two''' of the following, without a more plausible etiology:
* [[Cataracts]] or [[congenital]] [[glaucoma]],
* [[Congenital heart disease]] (most commonly [[Patent ductus arteriosus (PDA)|patent ductus arteriosus]] or peripheral [[pulmonary artery stenosis]]),
* [[Hearing impairment]], or
* Pigmentary [[retinopathy]];


OR
'''OR'''
An infant who does not have laboratory confirmation of rubella infection but has at least one or more of the following, without a more plausible etiology:
*[[Cataract]]s or congenital [[glaucoma]],
*[[Congenital heart disease]] (most commonly [[patent ductus arteriosus]] or peripheral [[pulmonary artery stenosis]]),
*[[Hearing impairment]] or
*Pigmentary [[retinopathy]]
AND one or more of the following:
*[[Purpura]]
*[[Hepatosplenomegaly]]
*[[Microcephaly]]
*[[Developmental delay]]
*[[Meningoencephalitis]] or
*Radiolucent bone disease


===Confirmed Case===
An [[infant]] who '''does not have laboratory confirmation of [[rubella]]''' infection but has '''at least one or more''' of the following, without a more plausible etiology:
* [[Cataracts]] or [[congenital]] [[glaucoma]],
* [[Congenital heart disease]] (most commonly [[Patent ductus arteriosus (PDA)|patent ductus arteriosus]] or peripheral [[pulmonary artery stenosis]]),
* [[Hearing impairment]], or
* Pigmentary [[retinopathy]];


An infant with at least one of the symptoms clinically consistent with congenital rubella syndrome listed above; and laboratory evidence of congenital rubella infection demonstrated by:
'''AND'''


*Isolation of [[rubella virus]] or detection of rubella-specific immunoglogulin M ([[IgM]]) antibody, or infant rubella antibody level that persists at a higher level and for a longer period of time than expected from passive transfer of maternal antibody (i.e., rubella titer that does not drop at the expected rate of a two-fold decline per month), or a specimen that is PCR-positive for [[rubella virus]].
'''One or more''' of the following:
* [[Purpura]],
* [[Hepatosplenomegaly]] ([[HSM]])
* [[Microcephaly]]
* [[Developmental delay]]
* [[Meningoencephalitis]], or
* Radiolucent [[bone disease]]
|-
!Confirmed
|An [[infant]] with '''at least one''' of the symptoms clinically consistent with congenital rubella syndrome listed above; and laboratory evidence of congenital rubella infection demonstrated by:
# Isolation of [[rubella virus]], '''OR'''
# Detection of [[rubella]]-specific [[immunoglobulin M]] ([[IgM]]) [[antibody]], '''OR'''
# [[Infant]] [[rubella]] [[antibody]] level that persists at a higher level and for a longer period of time than expected from passive transfer of maternal [[antibody]] (i.e., [[rubella]] [[titer]] that does not drop at the expected rate of a two-fold decline per month), '''OR'''
# A specimen that is [[PCR]]-positive for [[rubella virus]]
|-
!Infection only
|An [[infant]] '''without''' any clinical symptoms or signs of rubella but with laboratory evidence of infection demonstrated by:
* Isolation of [[rubella virus]], '''OR'''
* Detection of [[rubella]]-specific [[immunoglobulin M]] ([[IgM]]) [[antibody]], '''OR'''
* [[Infant]] [[rubella]] [[antibody]] level that persists at a higher level and for a longer period of time than expected from passive transfer of maternal [[antibody]] (i.e., [[rubella]] [[titer]] that does not drop at the expected rate of a two-fold decline per month), '''OR'''
* A specimen that is [[PCR]]-positive for [[rubella virus]]
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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{{WS}}
[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Neonatology]]
[[Category:Obstetrics]]
[[Category:Congenital disorders]]
[[Category:Infectious disease]]
[[Category:Syndromes]]
[[Category:Needs overview]]
{{WH}}
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Latest revision as of 21:03, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2], Dima Nimri, M.D. [3]

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Overview

In 2009, the CDC published the case classification of congenital rubella syndrome and divided into suspected cases, probable cases, confirmed cases and infection only, based on symptoms and/or laboratory findings.[1]

CDC Case Definitions

in 2009, the CDC published the following case definition for case classification of congenital rubella syndrome:[1]

Case Classification Criteria
Suspected An infant who does not meet the criteria for a probable or confirmed case but who has one or more of the following findings:
Probable An infant who does not have laboratory confirmation of rubella infection but has at least two of the following, without a more plausible etiology:

OR

An infant who does not have laboratory confirmation of rubella infection but has at least one or more of the following, without a more plausible etiology:

AND

One or more of the following:

Confirmed An infant with at least one of the symptoms clinically consistent with congenital rubella syndrome listed above; and laboratory evidence of congenital rubella infection demonstrated by:
  1. Isolation of rubella virus, OR
  2. Detection of rubella-specific immunoglobulin M (IgM) antibody, OR
  3. Infant rubella antibody level that persists at a higher level and for a longer period of time than expected from passive transfer of maternal antibody (i.e., rubella titer that does not drop at the expected rate of a two-fold decline per month), OR
  4. A specimen that is PCR-positive for rubella virus
Infection only An infant without any clinical symptoms or signs of rubella but with laboratory evidence of infection demonstrated by:

References

  1. 1.0 1.1 Center for Disease Control and Prevention https://www.cdc.gov/vaccines/pubs/surv-manual/chpt15-crs.html. Accessed on Jan 5, 2017

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