Congenital rubella in the USSR.

The results of a comprehensive study of the problem of congenital rubella in Moscow and other cities of the USSR are presented. The highest rubella incidence was found among children 1-7 years of age; but 20-25 rubella cases were also recorded annually per 100 000 adults. Specific antihaemagglutinins were found in 36-70% of children and in 91-99% of adults. Investigation of the rubella foci revealed clinical rubella, confirmed by laboratory methods, in children and adults who had low initial titres of specific antihaemagglutinins. Serological screening of 1661 apparently healthy pregnant women detected antihaemagglutinins in 98.4%; however, low (1:8-1:16) titres were found in 53.3% and high (postinfection) titres and specific IgM in only 8.8% of cases.A study of 523 pregnant women who had been in contact with a source of infection revealed clinical rubella in 10.9% and inapparent infection in 0.7% of cases. A virological study of fetuses from infected pregnant women showed that there was intrauterine viral infection in 73% of cases; 38% of rubella-infected fetuses had congenital defects (unilateral or bilateral cataract, absence of one cerebral hemisphere, adhesion of the upper and lower eyelid, or diffuse damage of the crystalline lens); in one woman rubella virus was isolated from the fetuses and abortion materials received from two abortions with an interval of 6 months. Serological investigation of 519 mothers who had given birth to children with congenital defects showed that there were more frequent indications of rubella infection in the mothers of the children with CNS and cardiovascular defects, as well as in the children with congenital cardiovascular and CNS defects, than in the control groups. These data confirmed the teratogenic nature of rubella strains found in the USSR. This study indicates the need to improve rubella surveillance in pregnant women and to consider the prophylaxis of congenital rubella in the USSR. (See also Addendum.)