Congenital Rubella Syndrome as a possible cause for persistent thrombocytopenia in early infancy: The Forgotten Culprit

Abstract We present a case of a late preterm intrauterine growth-restricted neonate with isolated and persistent severe thrombocytopenia. At birth, the neonate did not have a complete clinical spectrum of congenital rubella syndrome (CRS) but later developed peculiar findings that helped clinch the diagnosis. The neonate also had interstitial pneumonia and died secondary to superimposed acute viral infection leading to acute respiratory distress syndrome. The serology was positive for IgM antibodies against the rubella virus. The constellation of clinical manifestations of congenital rubella in the presence of positive IgM antibody against rubella and consistent histopathology confirmed the diagnosis of CRS.

Sí­ndrome da rubéola congênita: análise dos casos notificados no Brasil entre 1990 a 2016 / Congenital rubella syndrome: analysis of cases notified in Brazil from 1990 to 2016

Objetivo: analisar os casos de Síndrome da Rubéola Congênita notificados no Brasil durante o período de 1990 a 2016. Método: estudo transversal realizado no Brasil, cuja amostra foi de 122 casos notificados com Síndrome da Rubéola Congênita. Os dados foram disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. A coleta de dados foi realizada durante os meses de fevereiro e março de 2021. O tratamento dos dados se deu por análise estatística uni-variada. Resultados: observa-se prevalência no Estado de São Paulo cuja capital apresentou o maior número destas notificações. O ano em que houve prevalência do diagnóstico foi em 2008 e o mês de maior notificação foi dezembro. Todos os pacientes apresentavam idade menor que um ano, sexo feminino, com confirmação final para a doença por meio de critérios laboratoriais, e evolução para a cura. Conclusão: a idade apresentou significância no estudo. A terapêutica mostrou-se eficiente para um melhor prognóstico de cura, bem como a vacinação como medida preventiva.(AU)

Objective: to analyze the cases of Congenital Rubella Syndrome notified in Brazil from 1990 to 2016. Method: cross-sectional study conducted in Brazil, whose sample consisted of 122 cases notified with Congenital Rubella Syndrome. Data were made available by the Departamento de Informática do Sistema Único de Saúde. Data collection was conducted during February and March 2021. The data were processed using univariate statistical analysis. Results: prevalence was observed in the state of São Paulo, whose capital city had the highest number of these notifications. The year in which there was prevalence of the diagnosis was 2008, and the month of greatest notification was December. All patients were less than one year old, female, with final confirmation of the disease through laboratory criteria, and progression to cure. Conclusion: Age was significant in this study. Therapy proved to be efficient for a better prognosis of cure, as well as vaccination as a preventive measure.(AU)

Objetivo: analizar los casos de Síndrome de Rubéola Congénita notificados en Brasil entre 1990 a 2016. Método: estudio transversal realizado en Brasil, cuya muestra fue 122 casos notificados con Síndrome de Rubéola Congénita. Los datos fueron facilitados por el Departamento de Informática del Sistema Único de Salud. La recogida de datos se realizó durante los meses de febrero y marzo de 2021. El tratamiento de los datos se realiza mediante un análisis estadístico univariante. Resultados: se observa una prevalencia en el Estado de São Paulo, cuya capital presenta el mayor número de notificaciones. El año y mes en que se produjo la prevalencia del diagnóstico fue 2008 y diciembre. Todos los pacientes presentaban una edad inferior a un año, sexo femenino, con confirmación final de la enfermedad mediante criterios de laboratorio y evolución para la cura. Conclusión: la edad presentó un significado en el estudio. El tratamiento es eficiente para un mejor pronóstico de curación, así como la vacunación como medida preventiva.(AU)

Epidemio-clinical aspects of congenital rubella syndrome in Madagascar

Background: Congenital rubella syndrome is the first congenital defect preventable by vaccination. The purpose of this study was to provide basic information on the extent and epidemiology of congenital rubella syndrome in Madagascar.Methods: A retrospective and descriptive study from January 2013 to May 2019 was conducted in 8 hospitals in 2 provinces of Madagascar, Antananarivo and Toliara. The study included children who attended the services selected during the study period and who had the following conditions: children aged of 0 to 59 months, regardless of vaccination status, meeting the World Health Organization clinical criteria for congenital rubella syndrome with or without biological confirmation.Results: Of the 152,304 cases of children of all ages who visited or were hospitalized during the study period, 112 clinically confirmed cases of congenital rubella syndrome were identified. The age group 0 to 11 months involved 60 children (53.6%). Congenital heart disease was found in 83.0% of cases, mental backwardness in 43.7% and microcephaly in 26.8%. Twenty-three among (20.5%) them died. The death was due to cardiac diseases in 16 children.Conclusions: Findings confirm that the diagnosis of congenital rubella syndrome is underestimated in current pediatric practice in Madagascar. The introduction of the rubella vaccine in the Expanded Program on Immunization and the implementation of an effective and sustainable surveillance system for congenital rubella syndrome in the country is a proved effective tool for the prevention of this disease.