title: Surveillance of congenital rubella syndrome (CRS) in tertiary care hospitals in Hanoi, Vietnam during a rubella epidemic.
abstract: OBJECTIVE
  To describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam.
  
  
  METHODS
  Prospective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study.
  
  
  RESULTS
  During the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1-152 days) and 61% were female. Clinical manifestations of CRS included low birth weight<2500 g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92-1.34).
  
  
  CONCLUSIONS
  These preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential.
authors.affiliation: Department of Paediatrics, Hanoi Medical University, Hanoi, Viet Nam; Department of Paediatrics, Bachmai Hospital, Hanoi, Viet Nam. Electronic address: hongbang52@yahoo.com.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Bang
authors.affiliation: Department of Medical Education and Skill Laboratory, Hanoi Medical University, Hanoi, Viet Nam.
authors.forename: Nguyen Thi
authors.initials: NT
authors.lastname: Van Anh
authors.affiliation: Department of Microbiology, Bach Mai University Hospital, Hanoi, Viet Nam.
authors.forename: Vu Thi Tuong
authors.initials: VT
authors.lastname: Van
authors.affiliation: National Hospital of Paediatrics, Hanoi, Viet Nam.
authors.forename: Trieu Thi Hong
authors.initials: TT
authors.lastname: Thai
authors.affiliation: Department of Paediatrics, Saint Paul Hospital, Hanoi, Viet Nam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Thuong
authors.affiliation: National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, Sydney Medical School, The University of Sydney, NSW, Australia.
authors.forename: Gulam
authors.initials: G
authors.lastname: Khandaker
authors.affiliation: Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, Sydney Medical School, The University of Sydney, NSW, Australia; Australian Paediatric Surveillance Unit (APSU), Sydney, NSW, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Elliott
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012409:Rubella / Q000453:epidemiology*; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology* / Q000473:pathology*; D062606:Tertiary Care Centers; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M
keywords: Congenital rubella; Congenital rubella syndrome; Rubella; Vietnam