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March 13, 2002

“Congenital Rubella Syndrome: A Risk in Immigrant Populations” Lancet (www.thelancet.com) (02/23/02) Vol. 359, No. 9307, P. 674; Sheridan, E.; Aitken, C.; Jeffries, D.

In the United Kingdom, the case of a baby born with congenital rubella syndrome to a recent immigrant has highlighted the dangers of immigrants introducing diseases in developed countries.  In this case, a 20-year-old Bangladeshi primigravid arrived in the United Kingdom when she was 20 weeks pregnant. The rubella infection was not detected before birth.  Because the disease is easily transmitted to others, the baby was barrier-nursed in a side-room.  Despite these precautions, another baby was found to test positive for rubella virus IgM, although it did not appear to have developed postnatal or congenital rubella.  Babies infected with rubella secrete large quantities of the virus in their body fluids for up to 12 months after birth, which obviously poses a major risk of cross-infection.  There have been numerous documented cases of nosocomial spread of rubella from infected babies to hospital staff, but this appears to be the first documented case of the spread of the disease from infant to infant.  Many African and Asian countries do not have rubella vaccination programs, and this case highlights the need to maintain a high index of suspicion for this disease in recent immigrants from such countries.  The researchers suggest the introduction of “catch up” immunization programs for recent immigrants.

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