A search for congenital rubella in psychiatric day treatment, language and learning centres.

A search for previously undiagnosed congenital rubella (CR) was made on 672 children who had attended psychiatric day treatment, learning, and speech and language centres. This was done by observing the seroresponse of seronegative children to rubella vaccine, since 90% of patients with known CR who are seronegative fail to seroconvert to the vaccine. Of the 225 seronegative children 23 did not seroconvert after a single vaccination. Five of these failed to respond on revaccination. These five children had a high frequency of severe language and learning disability as well as frequent diagnoses of major CNS disorders. It is likely that a far greater number of children in the population studied had CR, since our methods identify only about 20% of those affected. Clinically, a specific diagnosis of CR is helpful in facilitating genetic counselling and in allowing the clinician to offer a more hopeful prognosis.