Clinical manifestations of congenital rubella syndrome: A review of our experience in Vietnam. Issue 1 (3rd January 2019)

• Record Type: Journal Article
• Authors: Toizumi, Michiko; Vo, Hien Minh; Dang, Duc Anh; Moriuchi, Hiroyuki; Yoshida, Lay-Myint
• Is Part Of: Vaccine. Volume 37:Issue 1(2019)
• Page Start: 202
• Page End: 209
• Publication Date: 2019-01-03
• Subjects: ASD autism spectrum disorder -- ASQ the Ages and Stages Questionnaire -- CARS2 Childhood Autism Rating Scale, second edition -- CRS congenital rubella syndrome -- Denver II the Denver Developmental Screening Test II -- DSM the Diagnostic and Statistical Manual of Mental Disorders -- M-CHAT Modified Checklist for Autism in Toddlers -- PH pulmonary hypertension -- RCV rubella-containing vaccine -- SNHL sensorineural hearing loss; Congenital rubella syndrome -- Rubella vaccine -- Clinical manifestations; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2018.11.046
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: The incidence of CRS is still rising in developing countries. Children with CRS present with a variety of disabilities. A timely multidisciplinary approach improves the quality of life in children with CRS. A timely multidisciplinary approach can be lifesaving in some children with CRS. Abstract: Rubella vaccination programs have dramatically reduced the incidence of rubella and congenital rubella syndrome (CRS) in developed countries. However, CRS prevalence is still rising in developing countries where rubella-containing vaccines (RCV) are not included in the immunization program and even in some countries where a part of the population lacks immunity to rubella despite the presence of RCV in the regular immunization program. This review aimed to summarize the clinical features of CRS using data from our studies conducted between 2011 and 2015 in Vietnam, wherein we examined clinical manifestations in Vietnamese children with CRS who were born after the large rubella outbreak of 2011; a series of studies dealing with CRS in North America and Europe after the 1960s epidemic; and those from countries before introduction of RCVs. This review shows that children with CRS have a variety of disabilities such as hearing, visual, developmental, behavioral, cardiac, and endocrine impairments, which have variable severity and may appear in different combinations. Some of these impairments can appear or worsen later in the lives of these children. Physicians should thus complete pediatric, cardiac, auditory, ophthalmologic, and neurologic examinations along with laboratory diagnostic testing soon after birth. These assessments should be repeated during follow-up if congenital rubella infection is suspected in a neonate. Timely intervention for cardiac defects can be lifesaving. Early introduction and continuation of speech, occupational, physical, and behavior therapies and training with appropriate medical interventions by a multidisciplinary team approach are required to maximize quality of life.