SIR Norman McAlister Gregg's report of "Congenital Cataract Following German Measles in the Mother"1 contained accurate and detailed descriptions of the clinical manifestations of congenital rubella which still provide a firm foundation for the intensive investigations completed during the subsequent 27 years. Gregg detected cataract, microphthalmia, nystagmus, retinopathy, intolerance to atropine, transient corneal clouding, patent ductus arteriosus, congestive heart failure, low birth weight, feeding difficulty, dermatitis, and high death rate which are characteristic of congenital rubella in early infancy; correlated these findings with maternal rubella "most frequently in the first or second month"; and pointed out that "other defects... may show up as development proceeds." Within two years Gregg could report that deafness and retardation were also important components of the rubella syndrome.2
Retrospective studies by many investigators indicated that the risk of congenital defect following maternal rubella approached 100% for infection during the first eight gestational weeks,
Cooper LZ, Ziring PR, Ockerse AB, Fedun BA, Kiely B, Krugman S. Rubella: Clinical Manifestations and Management. Am J Dis Child. 1969;118(1):18–29. doi:10.1001/archpedi.1969.02100040020004
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