Congenital - CongenitalViralInfections AnOverview...

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    Congenital Viral Infections An Overview
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Congenital, Perinatal, and Neonatal Viral Infections Intrauterine Viral Infections Rubella Cytomegalovirus (CMV) Parvovirus B19 Varicella-Zoster (VZV) Enteroviruses HIV HTLV-1 Hepatitis C Hepatitis B Lassa Fever Japanese Encephalitis Perinatal and Neonatal Infections Human Herpes Simplex VZV Enteroviruses HIV Hepatitis B Hepatitis C HTLV-1
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Rubella History 1881 Rubella accepted as a distinct disease 1941 Associated with congenital disease (Gregg) 1961 Rubella virus first isolated 1967 Serological tests available 1969 Rubella vaccines available
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Characteristics of Rubella RNA enveloped virus, member of the togavirus family Spread by respiratory droplets. In the prevaccination era, 80% of women were already infected by childbearing age.  
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Clinical Features maculopapular rash lymphadenopathy fever arthropathy (up to 60% of cases)
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Rash of Rubella
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Risks of rubella infection during  pregnancy Preconception minimal risk 0-12 weeks 100% risk of fetus being congenitally infected resulting in major congenital abnormalities. Spontaneous abortion occurs in 20% of cases. 13-16 weeks deafness and retinopathy 15% after 16 weeks normal development, slight risk of deafness and retinopathy
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Congenital Rubella Syndrome Classical triad consists of cataracts, heart defects, and sensorineural deafness. Many other abnormalities had been described and these are divided into transient, permanent and developmental. Transient low birth weight, hepatosplenomegaly, thrombocytopenic purpura bone lesions, meningoencephalitis, hepatitis, haemolytic anemia pneumonitis, lymphadenopathy Permanent Sensorineural deafness, Heart Defects (peripheral pulmonary stenosis, pulmonary valvular stenosis, patent ductus arteriosus, ventricular septal defect) Eye Defects (retinopathy, cataract, microopthalmia, glaucoma, severe myopia) Other Defects (microcephaly, diabetes mellitis, thyroid disorders, dermatoglyptic abnormalities Developmental Sensorineural deafness, Mental retardation, Diabetes Mellitus, thyroid disorder
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Outcome 1/3 rd will lead normal independent lives 1/3 rd will live with parents 1/3rd will be institutionalised The only effective way to prevent CRS is to terminate the pregnancy
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Antenatal screening All pregnant women attending antenatal clinics are tested for immune status
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Congenital - CongenitalViralInfections AnOverview...

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