National case definition: Congenital rubella syndrome/infection
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Date of last revision/review: May 2008
National notification
Only confirmed cases of disease should be notified.
Type of surveillance
Active, weekly case-by-case notification (including zero-notification) by provincial and territorial ministries of health to the Canadian Measles/Rubella Surveillance System (CMRSS)
Routine case-by-case notification to the federal level.
Case classification
Congenital Rubella Syndrome (CRS)
Confirmed case
Live birth: two clinically compatible manifestations (any combination from Table 1, Columns A and B) with laboratory confirmation of infection:
- isolation of rubella virus from an appropriate clinical specimen
or - detection of rubella virus RNA
or - positive serologic test for IgM antibody in the absence of recent immunization with rubella-containing vaccine
or - rubella IgG persisting for longer than would be expected (approximately six months after birth) from passive transfer of maternal antibody, or in the absence of recent immunization
Still birth: two clinically compatible manifestations with isolation of rubella virus from an appropriate clinical specimen
Probable case
In the absence of appropriate laboratory tests, a case that has at least
- any two clinically compatible manifestations listed in Table 1, column A
or - one manifestation listed in Table 1, column A, plus one listed in Table 1, column B
NOTE: The following cannot be classified as a case of CRS:
- rubella antibody titre absent in the infant
or - rubella antibody titre absent in the mother
or - rubella antibody titre declining in the infant consistent with the normal decline after birth of passively transferred maternal antibody
Congenital rubella infection
Confirmed case
Laboratory confirmation of infection but with no clinically compatible manifestations:
- isolation of rubella virus from an appropriate clinical specimen
or - detection of rubella virus RNA
or - positive serologic test for rubella IgM antibody in the absence of recent immunization with rubella-containing vaccine
or - rubella IgG persisting for longer than would be expected (approximately six months after birth) from passive transfer of maternal antibody, or in the absence of recent immunization
Laboratory comments
Further strain characterization is indicated for epidemiologic, public health and control purposes.
Clinical evidence
See Table 1
ICD code(s)
ICD-10 code
B06.0 plus G05.1, B06.9
P35.0 Congenital rubella
ICD-9/ICD-9CM code(s)
056.01 Encephalomyelitis due to rubella
771.0 Congenital rubella
| Column A | Column B |
|---|---|
|
|
Type of international reporting
Weekly reporting to the Pan American Health Organization, in accordance with the goal of eliminating rubella and congenital rubella syndrome in the Western Hemisphere.
Comments
Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.
Active weekly surveillance began in 2006. All cases are reviewed by the Immunization and Respiratory Infections Division (Public Health Agency of Canada) for classification before being added to the national database.
References
Pan American Health Organization. Elimination of Rubella and Congenital Rubella Syndrome Field Guide. Scientific and Technical Publication No. 606.
Previous case definitions
Canadian Communicable Disease Surveillance System: disease-specific case definitions and surveillance methods. Can Dis Wkly Rep 1991;17(S3).
Case definitions for diseases under national surveillance. CCDR 2000;26(S3).
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