RUBELLA, CONGENITAL
(Including Congenital Rubella Syndrome)

Clinical Criteria
Congenital rubella infection (CRI)
No clinical criteria can be defined for CRI
Congenital rubella syndrome (CRS)
Any infant < 1 year of age or any stillborn with:
– At least two of the conditions listed in (A)
OR
– One in category (A) and one in category (B)
(A)
– Cataract(s)
– Congenital glaucoma
– Congenital heart disease
– Loss of hearing
– Pigmentary retinopathy
(B)
– Purpura
– Splenomegaly
– Microcephaly
– Developmental delay
– Meningo-encephalitis
– Radiolucent bone disease
– Jaundice that begins within 24 hours after birth

Laboratory Criteria
At least one of the following four:
– Isolation of rubella virus from a clinical specimen
– Detection of Rubella virus nucleic acid
– Rubella virus specific antibody response (IgM)
– Persistence of rubella IgG between 6 and 12 months of age (at least two samples with
similar concentration of rubella IgG)
Laboratory results need to be interpreted according to the vaccination status

Epidemiological Criteria
Any infant or any stillborn born to a woman with a laboratory confirmed rubella infection
during pregnancy by human to human transmission vertical transmission)

Case Classification Congenital Rubella
A. Possible case    NA
B. Probable case
Any stillborn or infant either not tested OR with negative laboratory results with at least one
of the following two:
– An epidemiological link AND at least one category “A” CRS clinical criteria
– Meeting the clinical criteria for CRS
C. Confirmed case
Any stillborn meeting the laboratory criteria
OR
Any infant meeting the laboratory criteria AND at least one of the following two:
– An epidemiological link
– At least one category “A” CRS clinical criteria
An infant with positive laboratory criteria only without a history of rubella in the mother
during the pregnancy and without “A” clinical criteria will therefore be reported as rubella
case.