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], 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.

CDC Case Definitions

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

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: 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 or peripheral pulmonary artery stenosis), Hearing impairment, or 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, or Pigmentary retinopathy; AND 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