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. 2018 Sep 14;67(36):1012–1016. doi: 10.15585/mmwr.mm6736a4
   Suspected CRS. The presence of any of the following conditions in an infant:
  • Structural heart defect (excluding PDA or PFO in infants <37 weeks gestational age).

  • Hearing impairment.§

  • One or more of the following eye signs: cataract, microphthalmos, microcornea, congenital glaucoma, and pigmentary retinopathy.

  • Maternal history of suspected or confirmed rubella infection during pregnancy.

  • Strong clinical suspicion.

   Clinically confirmed CRS. The detection by a physician of two clinical signs from group A or one from group A and one from group B in an infant:
  • Group A: Cataract(s), congenital glaucoma, pigmentary retinopathy, congenital heart defect, or hearing loss.

  • Group B: Microcephaly, developmental delay, meningoencephalitis, splenomegaly, purpura, radiolucent bone disease, or jaundice with onset within 24 hours after birth.

   Laboratory-confirmed CRS. The presence in an infant of one condition from Group A (above) and one of the following laboratory criteria:
  • Detection of rubella IgM antibody; or

  • Sustained detectable rubella IgG antibody level, as determined on at least two occasions at age 6–12 months, in the absence of receipt of rubella vaccine.

   Congenital rubella infection. Absence of any clinical signs from group A in an infant with a positive rubella-specific IgM test.
   Clinically compatible case. Signs or symptoms of CRS in a patient from whom a blood specimen could not collected.
   Excluded noncase. A negative serologic result for rubella, irrespective of clinical signs present in an infant.
Abbreviations: IgG = immunoglobulin G; IgM = immunoglobulin M; PDA = patent ductus arteriosus; PFO = patent foramen ovale.
*Adapted from World Health Organization. Strategic plan for measles elimination and rubella and congenital rubella syndrome control in the South-East Asia Region. New Delhi, India: World Health Organization Regional Office for South-East Asia; 2015. (http://www.searo.who.int/entity/immunization/documents/sear_mr_strategic_plan_2014_2020.pdf).
Confirmed by echocardiography.
§ Confirmed by auditory brainstem response or auditory steady-state response audiometry.