Monitoring of congenital
rubella infection (CRI) involves measuring the assessable outcomes of
infection of the pregnant woman. These assessable outcomes are
infection itself,
therapeutic abortion, and birth of infants with
congenital rubella syndrome (CRS). The incidence of
infections can be estimated with use of data on age-specific occurrence of acquired
rubella or acquisition of antibody in females and on fertility rates. The incidence of CRS can be estimated from data on
infections of pregnant women and reports in the literature of incidence rates of CRS among infants born of infected mothers. Surveillance of CRS can involve individual case detection or serosurveys among populations with defects characteristic of CRS, such as
deafness, and among comparison groups. To assess the impact of CRI, countries without
rubella control programs should estimate the frequency of
infections in pregnant women from existing surveillance data or determine by serosurveys the susceptibility and/or age-specific acquisition of
rubella antibody in postpubertal females. Countries with
rubella control programs should monitor cases of acquired
rubella and/or prevalence of seropositivity in postpubertal females,
therapeutic abortions, and CRS to assess effectiveness of the program and to determine high-risk populations that should be targets of intense vaccination programs.