[Congenital rubella syndrome after maternal immunization]
[Article in Hebrew]
Miron D, On A.
Infectious Disease Unit, Porya Hospital, Tiberias.
A 2.5 year-old girl was found to have congenital rubella syndrome. She
presented with microcephaly, mild developmental delay, partial sensorineural
deafness and cerebellar atrophy. Blood titers of rubella hemagglutinin were
1/256 and 1/512 (exclusively IgG). She had not had rubella, nor had she been
immunized against it. The mother had been immunized against rubella 4 years
before her pregnancy with this girl and 2 years later blood hemagglutinin
titers were 1/32 and 1/64. She was neither exposed to nor suffered from
rubella during the pregnancy. Reinfection with rubella, extremely rare during
pregnancy, may occur in women whose hemagglutinin titers are lower than 1/64.
Rubella also occurs in women who have been immunized but whose titers,
similarly, are lower than 1/64. In some of these women the disease is
asymptomatic. In general, reinfection does not result in fetal injury, but
cases have been described in which babies of mothers infected in pregnancy
were born suffering from various degrees of congenital rubella syndrome.
after previous maternal immunity.
Das BD, Lakhani P, Kurtz JB, Hunter N, Watson BE, Cartwright KA, Caul EO,
Department of Microbiology, Milton Keynes General Hospital.
Two mothers who had asymptomatic
rubella infection in pregnancy gave birth to severely affected infants. In
both, the presence of preexisting antibody was well documented, although it
could not be established whether it was the result of vaccine or natural
Congenital rubella infection after previous immunity of the
Saule H, Enders G, Zeller J, Bernsau U.
II. Kinderklinik im Krankenhauszweckverband, Augsburg, Federal Republic of
A newborn boy was admitted with a
congenital rubella infection. Seven years previously his mother had been
vaccinated against rubella; 3 years previously rubella immunity had been
confirmed. Therefore, intrauterine transmission must have occurred
after maternal reinfection during pregnancy. Prenatal diagnosis of rubella
embryopathy with serological methods after subclinical maternal reinfection is
Rubella embryopathy after previous maternal rubella
Enders G, Calm A, Schaub J.
This report concerns a boy with
congenital rubella infection and features of the classical and expanded
rubella syndrome who was born to a mother who had been successfully vaccinated
vaccine seven years previously. The diagnosis of rubella embryopathy
was confirmed by demonstrating rubella-specific serum IgM antibodies using
four different methods, by the persistence of rubella HAI and IgG antibodies
in serum taken between three and eight months of age and by the isolation of
rubella virus from throat secretion, urine and blood mononuclear cells. The
child died at eight-and-a-half months of age. This case is discussed in
relation to the persistence of vaccine-induced immunity with particular
respect to the protective quality of low levels of antibodies against
intrauterine infection in the event of re-infection during pregnancy.
We report a case of a patient who had
a subclinical rubella infection in the first trimester of pregnancy which
resulted in the delivery of a baby suffering from congenital rubella.
Rubella virus vaccine, liver attenuated (Cendevax) vaccine had been
administered to the mother nearly three years before, with proven
seroconversion from a rubella haemagglutination-inhibition titre of 1:10 to
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