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Congenital rubella syndrome in Costa Rica: Importance of active surveillance

Abstract:

Objective: To identify cases of congenital rubella syndrome (CRS) and their form of presentation in children aged < 3 months in the National Children's Hospital of Costa Rica between 1996 and 2000. Methods: Between 1996 and 2000, patients aged 1 day to 3 months with positive IgM serology for rubella, identified by means of the computerized database of the National Children's Hospital Laboratory, were selected. Their corresponding medical records were reviewed and the characteristics of these patients were analyzed. Results: Sixty-six children with positive serology were identified, of which 49 had a complete medical record that allowed review. Of these, 29 (60%) were boys. The mean age at which IgM serology was requested was 33 days. The principal manifestations leading to serology were hepatosplenomegaly, microcephaly and multiple congenital anomalies. The initial diagnosis was TORCH infection. Of the 49 patients, 45 were classified as CRS and four as infection with rubella. Conclusions: The present study highlights the need to increase active surveillance of CRS. Greater vigilance in applying the criteria for clinical diagnosis is required to allow an adequate degree of suspicion and early reporting of cases.