Congenital rubella syndrome CDC case definitions

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

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CDC Case Definitions

Suspected Case

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
• Jaundice
• Microcephaly
• Developmental delay
• Meningoencephalitis
• Radiolucent bone disease

Probable Case

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 or peripheral pulmonary artery stenosis),
• Hearing impairment
• Pigmentary retinopathy

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:

• Cataracts or congenital glaucoma,
• Congenital heart disease (most commonly patent ductus arteriosus or peripheral pulmonary artery stenosis),
• Hearing impairment
• Pigmentary retinopathy

AND one or more of the following:

• Purpura
• Hepatosplenomegaly
• Microcephaly
• Developmental delay
• Meningoencephalitis
• Radiolucent bone disease

Confirmed Case

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 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.