[Acute neurologic rubella complications observed in children of southeastern Poland during rubella epidemics in 1986 and 1992]

Abstract

During the last two rubella epidemics in 1985-1986 and 1992, 24 children (15 boys and 9 girls) were hospitalized with acute neurological complications manifested in the first week of clinical symptoms of rubella. Average age of patients was 9 years (3-15 years). Acute rubella encephalitis (ARE) was diagnosed in 22 cases. Most of these patients had sudden loss of consciousness lasting from several hours to 12 days and convulsions during the first stage of the illness. Two patients developed retrobulbar neuritis which led to a significant impairment of sight in one of them. One child suffers epilepsy as a result of ARE. The remaining children did not develop lasting complications. During hospitalization, active infection by the rubella virus was confirmed in 20 children by detecting specific IgM antibodies in serum using the ELISA method. Comparing the ARE cases in 1986 and 1992 rubella epidemics revealed a change in clinical course. Earlier manifestations of neurological symptoms and more marked changes in CSF were observed. The issue of immunoprophylaxis is discussed; these measures only started in 1989 by vaccinating 13 and 14 year old girls. This method of prophylaxis will neither stop the transmission of the virus among children nor prevent the occurrence of periodic epidemics and rubella-related complications.