Rubella Epidemicity and Embryopathy

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Abstract
In a prospective study of 381 cases of maternal rubella observed to age 5 of the offspring, the incidence of major malformations was higher in the extensive outbreak of 1964 than in the period from 1957 to 1963 when the disease was less widespread. The rates were 54.2% and 30.6%, respectively, for cases occurring in the first trimester. The difference was largely due to a significantly higher incidence of congenital cataracts, deafness, and cardiac abnormalities in 1964 than in the previous seven years. The findings may be attributable either to increased teratogenicity of rubella virus prevalent in 1964 or to greater accuracy in clinical diagnosis of maternal rubella during the 1964 outbreak. An explanation based on a biological change in the virus is consistent with the extraordinary epidemicity of rubella in 1964.

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