Maternal Rubella in Iceland 1963-1964: Some Observations on 37 Children with Rubella Syndrome

Abstract

The rubella epidemic in Iceland 1963–1964 left in its wake an unprecedented percentage of handicapped children. A group of 37 children with rubella syndrome has been thoroughly investigated by a team of specialists. It is assumed that additional cases with minor problems are still undetected. Similar to other reported epidemics, the predominant characteristic of the rubella children has been a moderate to severe hearing loss. It is noteworthy, however, that not a single case of cataract or heart defect has been detected so far. Most of the children were found to have normal intelligence but social maturity was markedly retarded in most cases. Behavioral characteristics have been described as erratic, disoriented, dysphasic. It was found that preventive measures during the epidemic left much to be desired. It is evident from the present study that previous estimates of the risk of fetal damage based on retrospective studies are totally invalidated. Special education facilities, meagre as they were before the epidemic, are still suffering from the severe blow. Epidemien af Røde Hunde i Island 1963–64 efterlod i sit kølvand et uhørt antal handicappede børn. En gruppe på 37 børn med rubeola syndrom er blevet grundigt undersøgt af et hold specialister. Det antages, at yderligere tilfœlde med mindre problemer endnu ikke er opdaget. I lighed med andre refererede epidemier har det fremherskende kendetegn hos børn med Røde Hunde vœret et moderat til svœrt høretab. Det er imidlertid vœrd at lœgge mœrke til, at der indtil nu ikke er konstateret et eneste tilfœlde af Grå Stœr eller hjertefejl. Man fandt, at de fleste af børnene havde normal intelligens, men den sociale modning var tydeligt forsinket i de fleste tilfœlde. Adfœrdsmønstret er blevet beskrevet som vœrende ustadig, adspredt og dysfatisk. Man fandt, at de prœventive forholdsregler, der blev truffet under epidemien, lod meget tilbage at ønske. Nuvœrende undersøgelse har vist, at tidligere beregninger over risikoen for fødselsskader — baseret på retrospektive studier — er helt uholdbare. Faciliteterne for specialundervisning, dårlige som de var før epidemien, lider stadig under det alvorlige slag.