Presence of any defect(s) or laboratory data consistent with congenital
rubella infection. Infants with congenital rubella syndrome usually present with
more than one sign or symptom consistent with congenital rubella infection. However,
infants may present with a single defect. Deafness is most common single defect.
Laboratory criteria for diagnosis
Isolation of rubella virus, or
Demonstration of rubella-specific immunoglobulin M (IgM)
antibody, or
Infant rubella antibody level that persists at a higher
level and for a longer period than expected from passive transfer of maternal
antibody (i.e., rubella titer that does not drop at the expected rate of a
twofold dilution per month).
PCR positive rubella virus
Clinical case definition
An illness, usually manifesting in infancy, resulting from rubella
infection in utero and characterized by signs or symptoms from the following
categories:
a) Cataracts/congenital glaucoma, congenital heart
disease (most commonly patent ductus arteriosus or peripheral pulmonary artery
stenosis), hearing impairment, pigmentary retinopathy.
b) Purpura, hepatosplenomegaly, jaundice, microcephaly, developmental
delay, meningoencephalitis, radiolucent bone disease.
Case classification
Suspected: A case with some compatible
clinical findings but not meeting the criteria for a probable case.
Probable: A case that is not laboratory confirmed and
that has any two complications listed in paragraph “a” of the clinical case
definition or one complication from paragraph “a” and one from paragraph “b”,
and lacks evidence of any other etiology.
Confirmed: A clinically consistent case that is laboratory
confirmed.
Infection only: A case that demonstrates laboratory evidence
of infection, but without any clinical symptoms or signs.
Note
In probable cases, either or both of the eye-related findings (cataracts
and congenital glaucoma) count as a single complication. In cases classified as
infection only, if any compatible signs or symptoms (e.g., hearing loss) are identified
later, the case is reclassified as confirmed.