Most common presentation in congenital rubella syndrome is-

(C) (Nerve deafness) (1076-77 Nelson 19th)* Nerve deafness is the single most common finding among infants with congenital rubella syndrome (CPS)* Salt and pepper retinopathy are the most common ocular abnormality but have little early effect on vision.* Patent ductus arteriosis is the most frequently reported cardiac defect.* Classical Triad - cataract, deafness and CHDCongenital Rubella Syndrome (German measles or 3 day measles)* The risk of congenital defects has been estimated at 90% for maternal infection before 11 week of gestations, 33% at 11-12 week, 11% at 13 - 14 week and 24% 15-16 weeks.* In children, the 1st manifestation of rubella is usually the rash (begins on the face and neck, oropharynx may reveal tiny, rose-coloured lesions (Forchheimer spots) or petechial hemorrhages on the soft palate (Duration of the rash is generally 3 days)* Complications:(i) Thrombocytopenia - epistaxis, GI bleeding and hematuria.(ii) Arthritis - RA(iii) Encephalitis - most serious(iv) Progressive rubella panencephalitis (PRP)Other neurologic syndromes rarely G.B. syndrome and peripheral neuritis.(v) Myocarditis is a rare complication.* Vaccination - MMR (RA - 27/3) in two dose regimen at 12 - 15 month and 4-6 years of age.* Vaccine should not be administered to severely immuno compromised patients (eg transplant recepients) HIV infection.* Vaccine should not be administered during pregnancy.* Rubella vaccine is given 1-14 years of age (to intercept transmission)*** Presence of IgM antibody is diagnostic.Congenital Varicella Syndrome:* Occurs due to mother's infection (maternal varicella zoster) during 1st half of pregnancy before 20 weeks.* Manifestations of congenital varicella syndrome include:i. IUGR and LBWii. Cicatrising skin lesions (Cicatrix)iii. Limb hypoplasiaiv. Brain abnormalities - Microcephaly, cortical atrophy, dilated ventricles (ventriculomegaly)v. Eye-abnormalities - choriretiritis, micro ophthalmia, pendular nystagmus.