Rubella Virus Genome Diagnosis during Pregnancy and Mechanism of Congenital Rubella

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Abstract
Fetal infection with rubella virus was diagnosed based on the detection of viral genome in the fetus-derived tissues. While viral genomes were detected in 41 of those 112 cases (36.7%) where rubella virus infection of the mother was apparent, only 7 of 141 cases (5.0%) showed evidence of fetal infection when maternal rubella infection was inapparent. All 184 babies born of genome-negative mothers have no congenital disorder, while 2 out of 7 genome-positive babies have a congenital disorder (28.6%). Rubella virus was not transmitted across the placenta when infection occurred prior to gestation. Transmission rate increased to a maximum level during the first trimester and declined to 0% until 20 weeks of gestation. Interval of viral transmission from the onset of rash in the mother was about 10 days to the placental villi and 20–30 days to the fetus. A phylogenetic tree of 61 virus isolates suggested no difference of virulence/teratogenicity among the virus isolates.

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