Understanding progressive rubella pan encephalitis: a rare neurological disorder

Progressive rubella panencephalitis (PRP) is a rare late complication of rubella that affects mainly teenagers. It is characterized by progressive white matter destruction, gliosis and cerebral atrophy, similar to subacute sclerosing panencephalitis (SSPE) and congenital rubella syndrome. This paper examines the complexity of PRP, its clinical manifestations, pathogenesis, diagnostic criteria, treatment and prophylaxis. PRP should be considered in adolescents with progressive dementia with pyramidal and cerebral dysfunction. With respect to the most affected children, survival and recovery is expected to be poor, with high mortality rates, especially in the first six months of life. The development of progressive spasticity, ataxia, mental deterioration and convulsions in late childhood and early childhood with mothers' rubella or stigmata histories is the subject of research on PRP. Therefore, continued efforts to understand and address PRP are important to improve the quality of diagnosis, treatment and ultimately the quality of life of affected persons.

Case report of congenital rubella syndrome with sub aortic membrane non-coronary cusp perforation and patent ductus arteriosus

Rubella, a common viral infection caused primarily by the rubella virus, is still a global public health concern. Every year, about 30000 instances of congenital rubella syndrome are reported in India, according to health ministry surveillance. A case study of a 6-year-old boy with congenital rubella syndrome was presented here. The child presented with classic abnormalities of congenital rubella syndrome like hearing loss, vision problems, heart defects and intellectual disabilities. Among its many manifestations, congenital heart defects are life threatening, this child was planned for surgical correction of above cardiac lesions. Treatment modalities differ in each type of congenital heart defects and its early detection and surgical intervention can reduce childhood mortality and morbidity.

Case report of congenital rubella syndrome with sub aortic membrane non-coronary cusp perforation and patent ductus arteriosus

Rubella, a common viral infection caused primarily by the rubella virus, is still a global public health concern. Every year, about 30000 instances of congenital rubella syndrome are reported in India, according to health ministry surveillance. A case study of a 6-year-old boy with congenital rubella syndrome was presented here. The child presented with classic abnormalities of congenital rubella syndrome like hearing loss, vision problems, heart defects and intellectual disabilities. Among its many manifestations, congenital heart defects are life threatening, this child was planned for surgical correction of above cardiac lesions. Treatment modalities differ in each type of congenital heart defects and its early detection and surgical intervention can reduce childhood mortality and morbidity.

Seroprevalence of Rubella in a Subfertility Clinic of a Semi Urban Tertiary Care Private Hospital of Eastern India

Introduction: Primary maternal rubella virus infectionduring the first trimester of pregnancy carries a high risk fordevelopment of congenital rubella syndrome. According tothe estimate of World Health Organization, worldwide morethan 100,000 children are born with CRS each year. Mostof these children are born in developing countries. Severalguidelines suggest routine rubella serology testing in womentrying for pregnancy. Objectives: This study was conductedto assess immunity (seroprevalence) to rubella among Indianwomen of childbearing age attending subfertility clinic and toobserve the trend over the years.Material and methods: Women attending subfertility clinichad serum sample tested to determine the seropositivityas part of subfertility work up. Rubella seropositivity wasdetermined by estimating IgG antibodies to rubella virus usingCLIA method.Results: The study period was from January 2011 to December2018. Three hundred and seventy seven women were testedfor estimation of Rubella IgG. Overall seronegativity was29.4%. Interestingly this seronegativity rate was very similarover the study period, demonstrating overall nearly one-thirdof the subfertile women were susceptible to rubella.Conclusion: These observations indicate high rubellasusceptibility among women in the childbearing age grouptrying for pregnancy. There is a need for detection ofseroprevalence in subfertile population in Eastern India; sothat appropriate vaccination can prevent this preventabletragedy of perinatal / neonatal morbidity. Further study isneeded to determine the magnitude of problem in other settings(Government hospital, rural population, low socioeconomicstatus).

Sero-prevalence of unvaccinated adolescent girls susceptible to rubella virus infection seen in a tertiary care hospital of Patna, Bihar, India

Background: Rubella infection occurring during early pregnancy results in congenital rubella syndrome (CRS).  WHO estimates that worldwide more than 100,000 children are born with CRS each year and most of them are in the developing countries. For assessing population immunity against rubella, sero-surveys are generally recommended among adolescent girls and reproductive age female. In India, sero-surveys conducted by different authors have indicated that about 10-30% of adolescent females are susceptible to rubella infection. Adolescent girls are selected because they are at a critical stage of child bearing age and their immunity against Rubella infection is the particular area of interest. objective of this study was to estimate the sero-prevalence of unvaccinated adolescent girls susceptible to Rubella virus infection attending a tertiary care hospital of Patna and then accordingly counsel for vaccination.Methods: A total 150 adolescent girls in the age group of 10-19 years who had not received MMR vaccine were included in the study. Serum IgG antibody titer for rubella was estimated by the ELISA method.Results: A total 65.33% of the adolescent girls were found to be rubella seropositive and (34.67%) were seronegative. The urban adolescent girls had a higher seropositivity of 85.2% as compared to rural adolescent girls.Conclusions: The study indicates that a substantial number of adolescents (34.67%) are seronegative and hence susceptible to rubella infection.

Knowledge, attitude, and practice of care providers about congenital rubella syndrome

Background: Behaviour of healthcare providers when facing an illness is an important part of their struggle. The aim of this study was to assess the level of knowledge, the attitude and the practice of health care providers regarding to the Congenital Rubella Syndrome.Methods: Authors did a descriptive study on the knowledge, the attitude and the practice of healthcare providers about Congenital Rubella Syndrome with 161 healthcare providers working in 8 hospitals in Madagascar. A self-introduced survey was used to collect the data.Results: There were 87% of all healthcare providers included in the study, who said that rubella in the first trimester of pregnancy was the cause of this syndrome for child, 87% knew at least 2 of the 3 major signs of Congenital Rubella Syndrome and more than 80% had a good knowledge of the criteria for diagnosing cases (suspected, clinically confirmed, laboratory confirmed). The referral to a hospital or to a specialist was the most proposed for the management of the case of Congenital Rubella Syndrome. The prescription of an IgG avidity for rubella and advising abortion were the main propositions for mothers having a positive test at the first trimester of pregnancy.Conclusions: A fairly satisfactory level of knowledge of healthcare providers was noted.

Perception of parents of private school students on measles and rubella vaccination campaign in Sambalpur town

Background: In order to eliminate measles and rubella (congenital rubella syndrome) WHO has emphasized on measles and rubella (MR) vaccination campaign and India launched the ambitious MR Campaign with the help of WHO and GAVI. In Odisha the MR campaign was launched on January 29 with a target to cover nearly 1.13 crore children. The objective of the present study is to assess the knowledge of parents regarding measles and rubella infection and to identify the source of information regarding MR campaign. Methods: A cross-sectional study was conducted in Sambalpur City across 10 private schools during February 10 to March 12. Total 440 parents of children aged 5-15 years were given a questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards MR Campaign. The data were collected subsequently in the next 10 days. Out of 440 parents 408 returned filled up questionnaire. Data were entered into and analyzed by using Microsoft Excel.Results: Out of the 408 respondents 362 (88.7%) parents had knowledge about MR campaign. 156 respondents was aware about importance of rubella vaccine. Parent teacher meeting (PTM) was the leading source of information for these. 388 (95%) respondent’s children had received the vaccine during campaign.Conclusions: Parent-teacher's meeting was the main source of information. However social mobilisation such as street play, miking, rallies by school children and NGOs etc., needs to be taken up for such campaigns in future.

Seroprevalencia de anticuerpos IgG antirubéola y anticitomegalovirus en mujeres entre 16 y 40 años residentes en Tunja, Colombia / Seroprevalence of anti-rubella and anti-cytomegalovirus IgG antibodies in women aged between 16 and 40 years, living in Tunja, Colombia

RESUMEN Objetivo Determinar la seroprevalencia de anticuerpos IgG anti-rubéola y anti-citomegalovirus en un grupo de mujeres entre 16 y 40 años, residentes en Tunja. Métodos Investigación descriptiva de corte transversal, en la cual se incluyeron mujeres de 16 a 40 años, por medio de un muestreo no probabilístico por conveniencia. Las variables sociodemográficas fueron registradas mediante encuesta. Se empleó ensayo inmunoenzimático para la determinación cuantitativa de anticuerpos IgG frente a rubéola y citomegalovirus en suero. La estadística aplicada al estudio se llevó a cabo por medio del programa estadístico SPSS versión 21. Resultados El estudio incluyó un total de 154 mujeres en edad fértil, estableciéndose una seropositividad para IgG anti-rubéola de 96,1% (n=148) (IC 95% 93,0 - 99,1) y anti-citomegalovirus de 90,9% (n=140) (IC 95% 86,3 - 95,4). Conclusión Una de cada diez mujeres en estudio está en riesgo de adquirir una infección primaria por citomegalovirus y una de cada 30 por rubéola. El control prenatal por medio de determinaciones serológicas frente a citomegalovirus y rubéola durante el embarazo es primordial en estos casos.(AU)

ABSTRACT Objective To determine the seroprevalence of anti-rubella and anti-cytomegalovirus IgG antibodies in a group of women aged between 16 and 40 years, residents of Tunja. Methods Descriptive, cross-sectional research in women aged between 16 and 40 years included by means of non- probability sampling for convenience. Sociodemographic variables were recorded by applying a survey. An enzyme immunoassay was used for the quantitative determination of rubella and cytomegalovirus IgG antibodies in serum. The statistical analysis was carried out using the statistical program SPSS version 21. Results The study included 154 women of childbearing age, establishing seropositivity for anti-rubella IgG of 96.1% (n=148) (95%CI: 86.3 - 95.4) Conclusion One in ten women included in the study is at risk of primary cytomegalo-virus infection and one in 30 of rubella infection. Prenatal care using serological determinations of cytomegalovirus and rubella during pregnancy is essential in these cases.(AU)

Vacuna contra sarampión rubeola y paperas y su asociación con autismo: a 20 años de controversia / Vaccine against measles mumps and rubella and its association with autism: 20 years of controversy

Resumen En la presente revisión se ofrecen las pautas éticas que rigen el esquema con que debe ser aplicada la vacuna triple contra Sarampión Rubeola y Paperas. Se hace énfasis en la falta de datos clínicos que hayan asociado esta vacuna con el desarrollo de autismo en niños y se expone con base en evidencia científica los riesgos de la no vacunación en este grupo etario.

Abstract In the present review is offered the ethical guidelines that govern the scheme with which the triple vaccine against Measles Rubella and Mumps must to be applied. It emphasizes the lack of clinical data that have associated this vaccine with the development of autism in children and exposes based on scientific evidence the risks of non-vaccination in this age group.

Congenital rubella syndrome: A brief review of public health perspectives

Congenital rubella syndrome (CRS) is one of the most devastating congenital infections and yet the only one which is vaccine preventable and is a public health challenge for clinicians and policymakers across the developing world including India. The clinical manifestations of CRS include growth retardation, cardiac defects, cataracts, and hearing impairment. The World Health Organization (WHO) estimates that worldwide over 100,000 babies are born with CRS every year despite the availability of safe and inexpensive vaccines, thus highlighting the need for broader vaccination coverage programs. This article briefly reviews the importance of CRS, the proposed strategies for prevention by the WHO, and the 揜ubella initiative� that Government of India is launching in view of the recognition of CRS as a significant problem in India.

Síndrome de TORCH: Enfoque racional del diagnóstico y tratamiento pre y post natal: Recomendaciones del Comité Consultivo de Infecciones Neonatales Sociedad Chilena de Infectología, 2016 / TORCH Syndrome: Rational approach of pre and post natal diagnosis.: Recommendations of the Advisory Committee on Neonatal Infections. Sociedad Chilena de Infectología, 2016

Existen numerosas infecciones bacterianas, virales y parasitarias que pueden transmitirse desde la madre al feto o recién nacido (RN) y que significan un riesgo para él. El acrónimo TORCH se utiliza en forma universal para caracterizar a aquel feto o RN que presenta un cuadro clínico compatible con una infección congénita y que permite un enfrentamiento racional, tanto diagnóstico como terapéutico. El concepto tradicional de realizar un "test de TORCH" sin consideraciones específicas a cada paciente, hoy en día se considera no adecuado y ha sido reemplazado por exámenes específicos para patógenos específicos bajo circunstancias bien definidas. El presente documento revisa las características generales, epidemiológicas, patogénicas, diagnósticas y terapéuticas de los patógenos más frecuentemente involucrados en el estudio de pacientes con sospecha de TORCH.

There is a lot of bacterial, viral or parasite infections who are able to be transmitted vertically from the mother to the fetus or newborn which implicates an enormous risk for it. The TORCH acronym is used universally to refer to a fetus or newborn which presents clinical features compatible with a vertically acquired infection and allows a rational diagnostic and therapeutic approach. The traditional "TORCH test" is nowadays considered not appropriate and it has been replaced for specific test for specific pathogens under well defined circumstances. The present document reviews the general characteristics, epidemiology, pathogenesis, diagnostic and therapeutic options for the most frequently involved pathogens in the fetus or newborn with TORCH suspicion.

Síndrome de TORCH: enfoque racional del diagnóstico y tratamiento pre y post natal. Recomendaciones del Comité Consultivo de Infecciones Neonatales Sociedad Chilena de Infectología, 2016 / TORCH syndrome: Rational approach of pre and post natal diagnosis and treatment. Recommendations of the Advisory Committee on Neonatal Infections Sociedad Chilena de Infectología, 2016

There is a lot of bacterial, viral or parasite infections who are able to be transmitted vertically from the mother to the fetus or newborn which implicates an enormous risk for it. The TORCH acronym is used universally to refer to a fetus or newborn which presents clinical features compatible with a vertically acquired infection and allows a rational diagnostic and therapeutic approach. The traditional "TORCH test" is nowadays considered not appropriate and it has been replaced for specific test for specific pathogens under well defined circumstances. The present document reviews the general characteristics, epidemiology, pathogenesis, diagnostic and therapeutic options for the most frequently involved pathogens in the fetus or newborn with TORCH suspicion.

Existen numerosas infecciones bacterianas, virales y parasitarias que pueden transmitirse desde la madre al feto o recién nacido (RN) y que significan un riesgo para él. El acrónimo TORCH se utiliza en forma universal para caracterizar a aquel feto o RN que presenta un cuadro clínico compatible con una infección congénita y que permite un enfrentamiento racional, tanto diagnóstico como terapéutico. El concepto tradicional de realizar un "test de TORCH" sin consideraciones específicas a cada paciente, hoy en día se considera no adecuado y ha sido reemplazado por exámenes específicos para patógenos específicos bajo circunstancias bien definidas. El presente documento revisa las características generales, epidemiológicas, patogénicas, diagnósticas y terapéuticas de los patógenos más frecuentemente involucrados en el estudio de pacientes con sospecha de TORCH.

Using the two-source capture–recupture method to estimate the incidence and case ascertainment of congenital rubella syndrome in Australia, 1993–2013

To verify rubella and CRS elimination, countries need to ensure that their surveillance systems are sufficiently sensitive to capture almost all cases. This study aims to estimate the incidence of CRS in Australia and the sensitivity of CRS case ascertainment in the NNDSS.

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013

INTRODUCTION: During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. METHODS: Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. RESULTS: A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. DISCUSSION: Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well-planned and funded vaccination activities can prevent future CRS cases.

Impact of rubella vaccination on elimination of congenital rubella syndrome in Sri Lanka: progress and challenges.

Rubella infection in pregnancy can lead to pathologies, including miscarriage, stillbirth and congenital rubella syndrome (CRS) in the neonate. Rubella vaccination can prevent all occurrences of CRS. In Sri Lanka, significant outbreaks of CRS occurred in 1994 and 1995, with 275 and 212 reported cases. In 1996, Sri Lanka introduced rubella vaccination for women aged 16–44 years, to stop CRS. Measles–rubella vaccine was introduced into the routine immunization schedule in 2001 and additional campaigns were carried out in 2003 (all 11–15 year olds) and 2004 (all 16–20 year olds). Reported immunization coverage with a single dose of a rubella-containing vaccine has been more than 95% since 2000. Laboratorysupported surveillance for rubella and CRS was started in 1992. Reported rubella cases fell from 364 (incidence 19/million population) in 1999 to 96 cases (incidence 5/million population) in 2002 and further to 12 cases (incidence 0.6/ million population) in 2014. Laboratory-supported CRS surveillance was started in 1990 and the highest number of CRS cases, 275 (incidence 77/100 000 live births), was diagnosed in 1994. Reported CRS cases fell from 22 cases (incidence 7/100 000 live births) in 2002 to 3 cases (incidence <1/100 000 live births) in 2014. Almost 20 years of routine rubella vaccination has resulted in >96% reduction in reported rubella cases and a corresponding >98% reduction in CRS cases. Despite this great achievement, work remains to eliminate rubella and CRS from Sri Lanka.

Congenital Rubella Syndrome - A Major Review and Update.

Rubella is a major public health problem which is usually a mild rash illness in children and adults. However, it has devastating systemic consequences when rubella virus crosses the placental barrier and infects fetal tissue resulting in congenital rubella syndrome (CRS). Congenital rubella syndrome is an under-recognized public health problem in Bangladesh and the burden of the disease weighs heavily on patients and society; therefore, routine vaccination and other preventative strategies are strongly encouraged. Extensive surveillance studies should be conducted to eliminate CRS from our country. In this review, we will characterize the epidemiology of CRS; describe the patho-phyisiology, clinical features and laboratory testing for the disease, and discuss measures needed for prevention of rubella and CRS

Búsqueda retrospectiva del síndrome de rubéola congénita en niños menores de 1 año / Retrospective search for Congenital Rubella Syndrome in Children under one year

Antecedentes: Costa Rica estableció la meta de eliminación del síndrome de rubéola congénita desde el año 2000. Datos oficiales de vigilancia reportan el último caso autóctono confirmado en el 2001. Para evaluar si se logró la meta de eliminación de la enfermedad se analizó, mediante una búsqueda retrospectiva, la calidad de la vigilancia del síndrome para determinar la existencia de casos que no fueron capados por el sistema vigente...

Congenital Rubella Syndrome: An Overview of Clinical Presentations in Bangladeshi Children.

Background: Congenital Rubella Syndrome (CRS) has long been characterized by the triad of deafness, cataract and cardiovascular malformations with or without mental retardation. Objective: This study was conducted to observe the clinical manifestations of CRS in children of Bangladesh. Materials and method: This cross sectional study was carried out in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. Total 40 cases of CRS were enrolled from indoor and outpatient departments of these two hospitals, who were diagnosed according to standard case definition. Serological test for rubella antibody, chest X-ray, colour Doppler echocardiography, visual examination and hearing assessment were done in relative specialised centres. Results: The mean(±SD) age of the study subjects was 6.6(±5.7) months (range: 0-24 months). Among the subjects, 68% were male and 32% were female. Serum for rubella specific antibody revealed positive IgG in 60% cases and IgM in 28% cases. Neurological problem was the most frequently observed (90%) systemic complication followed by visual problem (83%), congenital hearing loss (80%) and congenital heart disease (78%). Cataract was the commonest (55%) among visual problems and microcephaly (62%) among neurological manifestations. Patent ductus arteriosus (PDA) was the most common (37.5%) isolated structural cardiac defect. Maximum (62.5%) children came from poor socioeconomic status. Maternal onset of infection was commonly detected in 1st trimester of pregnancy. Conclusion: Diagnosis of CRS and recognition of its versatile pattern of clinical presentation are crucial for better prognosis of the affected children.

Vacinação contra rubéola em mulheres em idade reprodutiva no Município de Campinas, São Paulo, Brasil / Rubella vaccination in women of childbearing age in Campinas, São Paulo State, Brazil / Vacunación contra la rubeola de mujeres en edad reproductiva en el municipio de Campinas, São Paulo, Brasil

As mulheres em idade reprodutiva são a população de maior interesse para a prevenção da síndrome da rubéola congênita. O objetivo do trabalho foi avaliar a prevalência de vacinação contra rubéola em mulheres e identificar fatores associados e motivos da não adesão. Trata-se de estudo transversal de base populacional, realizado em Campinas, São Paulo, Brasil, em 2008/2009, com amostra por conglomerados e em dois estágios. Das 778 mulheres de 10 a 49 anos, 83,8% (IC95%: 79,6-88,0) referiram vacinação em algum momento da vida. Faixa etária (30-39 anos), renda familiar per capita superior a três salários mínimos e a orientação de profissional de saúde estiveram positivamente associadas à vacinação contra a rubéola. Os principais motivos da não adesão foram a falta de orientação do profissional de saúde sobre sua importância (48,5%) e não considerá-la necessária (18,9%). A recomendação do profissional de saúde foi o fator mais fortemente associado à adesão das mulheres à vacinação. Nesse sentido, sua indicação pelas equipes de saúde pode ampliar o conhecimento sobre sua importância e seus benefícios.

Women of reproductive age are the population of greatest interest for the prevention of congenital rubella syndrome. The aim of this study was to evaluate the prevalence of rubella vaccination in women and to identify factors associated and motives for non-adherence. A cross-sectional population-based study, in Campinas, São Paulo State, Brazil, in 2008/2009, was carried out with stratified random, two-stage cluster sampling. Of the 778 women aged 10 to 49 years, 83.8% (95%CI: 79.6-88.0) reported vaccination in life. Age group (20-39 years), per capita household income greater than 3 times the minimum wage and orientation of health care professionals about the vaccine, were positively associated with rubella vaccination. The main motives for non-adherence were lack of orientation of professionals about their importance (48.5%) and not consider it necessary (18.9%). The recommendation of professionals was the factor most strongly associated with women's adherence to vaccination. In this sense, an indication of vaccination by health care teams can increase the knowledge about the importance their and benefits.

Las mujeres en edad reproductiva son la población de mayor interés para la prevención del síndrome de la rubeola congénita. El objetivo del trabajo fue evaluar la prevalencia de vacunación contra la rubeola en mujeres e identificar factores asociados y motivos de la no adhesión al programa de vacunación. Se trata de un estudio transversal de base poblacional, realizado en Campinas, São Paulo, Brasil, en 2008/2009, con una muestra por conglomerados y en dos fases. De las 778 mujeres, de 10 a 49 años, un 83,8% (IC95%: 79,6-88,0) informaron de vacunación en algún momento de la vida. La franja de edad (30-39 años), renta familiar per cápita superior a tres salarios mínimos y la orientación de un profesional de salud estuvieron positivamente asociadas a la vacunación contra la rubeola. Los principales motivos de la no adhesión fueron la falta de orientación del profesional de salud sobre su importancia (48,5%) y no considerarla necesaria (18,9%). La recomendación del profesional de salud fue el factor más fuertemente asociado a la adhesión de las mujeres a la vacunación. En este sentido, su indicación por los equipos de salud puede ampliar el conocimiento sobre su importancia y sus beneficios.

A Case of Congenital Rubella Syndrome

PURPOSE: We report a case of congenital rubella syndrome with bilateral zonular cataracts. CASE SUMMARY: A 69-year-old man visited the hospital with visual disturbance in both eyes. His mother had been diagnosed with rubella during pregnancy, exhibiting typical fever and rashes. His visual acuity and hearing ability had been poor since birth. Corrected visual acuity was 0.3 in the right eye and 0.4 in the left eye. Slit lamp examination revealed bilateral zonular cataracts. On pure tone audiometry test, pure tone hearing threshold was 73 dB in the right ear and 72 dB in the left ear, corresponding to severe hearing loss in both ears. Echocardiogram showed a 1.5 cm-sized ostium secundum atrial septal defect, causing atrial fibrillation. Laboratory workup revealed an extremely high level of IgG antibody (titer = 1:301), and negative IgM antibody. A rubella IgG avidity test was 95.5%, suggesting remote rubella infection. Chromosomal analysis from peripheral blood did not show any abnormalities. The patient was diagnosed with congenital rubella syndrome with bilateral zonular cataracts. Two months after cataract surgery on both eyes, visual acuity steadily improved to 1.0 in both eyes. CONCLUSIONS: Congenital rubella syndrome is comprised of physical abnormalities such as sensorineural hearing loss, eye defects including congenital cataract, and cardiovascular defects due to gestational rubella infection. The possibility of congenital rubella syndrome should be considered even in old age, and a systemic multi-organ approach is necessary for therapeutic planning.