Rubella is a highly contagious, mild, viral infection. It is usually self-limiting, but in pregnancy, specifically in the first trimester, rubella poses significant risks. Rubella in pregnancy can have severe consequences for the fetus, including miscarriage, stillbirth and a range of congenital anomalies known collectively as congenital rubella syndrome. These anomalies are associated with lifelong complications, such as hearing impairment, cardiac defects, cataracts and neurodevelopmental delays. This article explores the background and epidemiology of rubella, recent global trends in reported rubella cases and rubella prevention and immunisation policies. It will also explore the role of the midwife in the context of rubella. In pregnancy, midwives are often the first point of contact for women, and are responsible for immunity screening, educating around the risks of rubella and facilitating vaccinations in the postnatal period.

Congenital infections cause stillbirth, prematurity, birth defects, and neonatal death, representing a major preventable cause of infant morbidity and mortality. In Brazil, data on their hospital burden remain limited. This retrospective, population-based time series study analyzed hospitalizations of infants (<12 mo) primarily associated with congenital syphilis, toxoplasmosis, rubella, cytomegalovirus, or herpes in Brazil's Unified Health System (SUS) from 2008 to 2024. Data were extracted from the SUS Hospital Information System (SIH). Hospitalizations were evaluated by annual volume, population-adjusted rates, mean and total costs, intensive care unit (ICU) use, length of stay (LOS), and in-hospital mortality, stratified by region. Temporal trends were examined using Spearman's correlation and group differences using one-way ANOVA. A total of 194,531 hospitalizations were recorded, representing a 394% increase from 4,449 in 2008 to 20,971 in 2024. Congenital syphilis accounted for 88% of admissions and increased across all regions, while toxoplasmosis and cytomegalovirus rose moderately and rubella declined following immunization. National hospital expenditures reached US$49.1 million, rising 170% over the period. Mean LOS decreased modestly (-.8 d), and ICU use remained low except for herpes (up to 32%). In-hospital mortality declined from .73% to .13%, but 29.5% of patients were hospitalized outside their municipality of residence, indicating persistent regional disparities. Hospitalizations due to congenital infections-predominantly syphilis-have increased substantially in Brazil, reflecting gaps in prenatal screening, partner management, and maternal-child health coordination. Despite declining mortality, regional inequalities in hospitalization rates, access, and costs persist.

Since 1993, the Australian Paediatric Surveillance Unit (APSU) has been conducting prospective national surveillance of rare conditions in Australian children, including communicable diseases and complications of communicable diseases. In 2024, fifteen communicable diseases and complications were under APSU surveillance: acute flaccid paralysis (AFP); congenital cytomegalovirus (cCMV) infection; dengue; severe acute hepatitis; neonatal/infant herpes simplex virus (HSV) infection; perinatal exposure to human immunodeficiency virus (HIV); paediatric HIV infection, juvenile-onset recurrent respiratory papillomatosis (JoRRP); severe complications of influenza (Flu); Japanese encephalitis virus infection; paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS); Q fever; congenital rubella infection/syndrome; congenital varicella syndrome; and neonatal varicella infection. A total of 1,350 paediatricians and other child health specialists received the monthly APSU report card (97% electronically) in 2024. A total of 237 notifications were received, with 174 confirmed as incident cases after excluding duplicates, errors and prevalent (historic) cases not previously reported. The incident cases included: Flu (n = 34) - one child died and only two children had received influenza vaccination; JoRRP (n = 1); NVI (n = 1); cCMV (n = 26); HSV (n = 8) - neurological sequelae were common; perinatal exposure to HIV (n = 15) - no cases of mother-to-child transmission identified; and rare emerging diseases dengue (n = 4) and PIMS-TS (n = 2). The non-polio AFP rate of ≥1case per 100,000 children aged < 15 years was again achieved. The APSU continues to be an important mechanism for obtaining enriched data on rare communicable diseases and their complications in Australian children, to better understand disease burden, and the effects of health interventions, over time.

BackgroundRubella virus infection is a clinically mild illness, but it can have serious effects on pregnant women, such as miscarriage, stillbirth, or congenital rubella syndrome. However, rubella is neither a notifiable disease nor part of an immunization program in Ethiopia. A suspected case of rubella has been reported in Adigrat since November 26, 2023. The study aimed to investigate and control the suspected rubella outbreak.MethodsFollowing the descriptive study, a case-control study was conducted in Adigrat town from December 23, 2023, to March 30, 2024. Cases were people who presented with fever and maculopapular or laboratory-confirmed cases or epidemiologically linked with the confirmed person, and controls were neighbours to a case with no signs and symptoms of rubella. Cases were selected using simple random sampling, and controls were the two closest neighbours per case. Data was collected using a semi-structured questionnaire and analysed with SPSS version 27. Logistic regression was used to determine the association of illness with risk factors, and the results were tested using OR, a 95% confidence interval.ResultA total of 350 cases of rubella were identified with an attack rate of 3.16/1000. The attack rate was high in children aged five to nine years (11/1000) and in kebelle 04 (8/1000). Five out of seven samples were tested positive for rubella-specific IgM antibodies. Having contact in a school setting (AOR = 7.063: 95% CI = 3.269–15.256), having household contact (AOR = 6.551:95%CI = 2.534–16.941) and ≥ 5 family size (AOR = 2.312:95%CI = 1.090–4.907) were significantly associated with rubella.ConclusionThe overall attack rate of the rubella outbreak was high, with a predominance of children under fifteen. Large family size, and having contact with infected individuals, were contributing factors for contracting rubella. Rubella vaccine should be considered to prevent similar outbreaks.

BackgroundRubella virus (RuV), a single stranded RNA virus, has detrimental effects in pregnancy due to miscarriage and congenital rubella syndrome. RuV was declared eliminated from the United States in 2004 due to successful implementation of the combined measles, mumps, and rubella (MMR) vaccine.1 Despite this eradication, rubella virus (RuV)-associated granulomas have been reported in the literature but are limited to case reports and series, with no reported prevalence rate.2 This study aims to assess the prevalence of cutaneous RuV granulomas and to further characterize the disease.Table 1:Characteristics of patients by rubella statusTable 2:Granulomatous disease presentation and referral diagnosisMethodsA multicenter retrospective cohort study of adult patients with atypical granulomas on histopathology, defined as suppurative granulomatous inflammation without an infectious cause or a granulomatous pattern without a specified diagnosis, were included. RuV immunostaining was performed on paraffin-embedded cutaneous tissue by the Centers for Disease Control and Prevention (CDC). Demographics and record review were collected.ResultsOf 117 patients, 71 were RuV-positive (61%) with a mean age of 53.44 ± 15.35; 61% were female (Table 1). RuV-positive lesions predominantly occurred on the extremities (80%, p=0.04) followed by head/neck (7%) and trunk (7%). Known immunocompromised status was not more prevalent in RuV-positive cases compared to RuV-negative (p=0.31). A third of cases came from outside referrals with a presumed diagnosis of both infectious and noninfectious etiologies (Table 2). Of the RuV-positive cases, 77% received one or more therapies. Biologics were used for 27% of patients, with TNF inhibitors most commonly used (72%).ConclusionIn this study, a high number of atypical cutaneous granulomas are positive for RuV (61%) with a predilection for the extremities. Atypical granulomas with extensive and unrevealing results should prompt testing for RuV. Future directions include thorough evaluation of patients, potential shedding into the environment and identification of best therapeutic interventions, including effective anti-virals against RuV. There is a need for prospective analysis to determine if RuV is vaccine-derived or wild type to further support public health interventions.DisclosuresMisha Rosenbach, MD, Johnson & Johnson: Advisor/Consultant|Merck: Advisor/Consultant|Novartis: Advisor/Consultant|Priovant: Advisor/Consultant|Priovant: Grant/Research Support Bridget Shields, MD, Priovant Therapeutics: Advisor/Consultant|UpToDate: Chapter Author Beth Drolet, Md, Arkayli: Board Member|Arkayli: Owner|Arkayli: Ownership Interest Megan Noe, MD, MPH, MSCE, Boehringer Ingelheim: Advisor/Consultant|Boehringer Ingelheim: Grant/Research Support|Bristol Meyer Squibb: Grant/Research Support|Sanofi: Employee|Takeda: Advisor/Consultant

Relevance . Rubella remains a significant public health concern despite substantial progress in its elimination in many countries worldwide. Disruptions to routine immunization programs during the COVID-19 pandemic, uneven vaccination coverage in certain regions, and the presence of population groups create conditions for the continued risk of importation, localized outbreaks, and the occurrence of congenital rubella syndrome. Aim. To analyze the current epidemiological situation of rubella worldwide and in the Russian Federation, assess trends in incidence and vaccination coverage, and review key approaches to vaccination strategies and maintenance of elimination status. Conclusion . The analysis demonstrates persistent heterogeneity in the epidemiological situation of rubella across different regions of the world despite an overall decline in incidence. Even in countries that have achieved elimination, the risk of renewed transmission persists in the presence of unvaccinated cohorts and population groups at increased risk. Maintaining elimination status requires high vaccination coverage, effective epidemiological surveillance, and the implementation of catch-up immunization campaigns, with particular emphasis on the prevention of congenital rubella syndrome.

Introduction: Seroprevalence of antibodies for vaccine-preventable diseases (VPDs), due to vaccination or previous infection, can provide a more accurate estimate of immunity compared to vaccination coverage data alone. This study aimed to examine the seroepidemiology and spatial distribution of VPD seroprevalence in Samoa in 2018 and 2019. Methods: Dried blood spot (DBS) samples were collected from two nationally representative community-based surveys of participants aged ≥5 years from the Surveillance and Monitoring to Eliminate Lymphatic Filariasis and Scabies from Samoa (SaMELFS) project. DBSs were tested using multiplex bead assays (MBAs) to detect antibodies against measles, rubella, diphtheria, and tetanus. Seroprevalence was estimated at the national and primary sampling unit (PSU) levels, and cluster analysis was completed using SaTScan. Results: Overall, 8394 valid MBA results were analysed across 35 PSUs. The highest overall seroprevalence was observed for tetanus (91.0%; 95% CI: 90.2–91.7), followed by diphtheria (83.7%; 95% CI: 82.7–84.7), rubella (79.3%; 95% CI: 78.2–80.3), and measles (45.8%; 95% CI: 44.8–46.9) with substantial heterogeneity across PSUs. Clusters of seronegativity to measles (relative risk [RR]: 1.16, p < 0.001) and diphtheria (RR: 1.16, p < 0.001) were also identified. Conclusions: These findings demonstrate significant variation in seroprevalence and pockets of low population immunity to multiple VPDs, highlighting the key advantage of an integrated rather than siloed approach. The relatively high seroprevalence to rubella suggests potential community transmission, emphasising the need to strengthen congenital rubella surveillance and improve vaccination coverage. Identifying low immunity to VPDs can provide an early warning to potential outbreak risk and support the Ministry of Health to target public health interventions in higher-risk areas.

This literature review examines the epidemiology, clinical profile, diagnosis, and management of Congenital Rubella Syndrome (CRS), focusing on endemic regions. Despite global success in reducing cases to 32,000 by 2019, severe disparities persist, particularly in Southeast Asia. Indonesia reported 229 cases in 2021, constituting 57% of the total regional burden, highlighting critical immunization gaps. The clinical findings confirmed the CRS triad, with hearing impairment being the most prevalent sequela. Management is strictly preventative, as no curative treatment exists. Diagnosis relies on serological confirmation and early screening, given the high rate of diagnosis in the month age group. This review advocates for aggressive RCV campaigns for women of childbearing age, coupled with urgent neonatal screening protocols for auditory and ocular defects to ensure timely surgical and rehabilitative intervention, mitigating the lifelong developmental costs of the syndrome.

Vaccine-preventable diseases (VPDs) remain a significant contributor to global ocular morbidity, yet their ophthalmic manifestations are often underrecognized. This review synthesizes current evidence on viral and bacterial VPDs with ocular involvement, highlighting a spectrum of presentations-from conjunctivitis to keratitis, uveitis, and optic neuritis. Such infections may affect a range of ocular tissues through mechanisms including direct viral invasion, immune-mediated inflammation, and secondary complications. While the frequency and severity of ocular involvement vary among pathogens, the potential for permanent vision loss, particularly in unvaccinated or immunocompromised individuals, underscores the clinical and public health importance of early recognition and prevention. Conditions such as congenital rubella syndrome, herpes zoster ophthalmicus, and acute retinal necrosis illustrate the breadth of pathology, while emerging infections like COVID-19 and monkeypox further expand the spectrum. Vaccination remains the most effective strategy for mitigating both systemic and ophthalmic sequelae. Greater awareness of ocular manifestations can facilitate earlier diagnosis, enhance outbreak detection, and reinforce the critical role of immunization in preserving vision.

Serologic screening for anti-rubella immunoglobulin G antibodies in Romanian pregnant women: an unexpected rate of seronegativity.

Background: Rubella infection poses significant risks during pregnancy, including miscarriage and Congenital Rubella Syndrome (CRS). This study assessed the knowledge, attitudes, and practices (KAP) regarding Rubella vaccination among female medical students. Methods: A cross-sectional, questionnaire-based study was conducted in June 2018 among 150 female MBBS students at a tertiary care centre in South India. Data on demographics, knowledge of Rubella and its vaccine, vaccination history, and willingness to promote Rubella awareness were collected. Results: Among the 150 participants, 60 were final year, 50 pre-final, and 40 pre-clinical students. Most were from urban areas and middle-income families. While all students recognised Rubella’s complications in pregnancy, detailed knowledge of the vaccine (type, dosage, route) varied by year. Vaccination coverage was 82%, but only 58% had completed the full schedule. Among unvaccinated students, 95% were willing to get vaccinated. Nearly all participants expressed a positive attitude towards Rubella prevention and showed readiness to engage in awareness and surveillance activities. Conclusion: Although general awareness about Rubella was high, detailed vaccine knowledge and full coverage need improvement. Targeted educational interventions are recommended to strengthen vaccination practices and advocacy among medical students.

Introduction: rubella infection in the first trimester of pregnancy can cause fetal organ damage and manifest as congenital rubella syndrome (CRS) in live-born babies. Global estimates indicate that 25,000 cases of CRS occur annually in the WHO African Region, most of whom occur in countries that do not provide rubella vaccination in their immunization programs. Ethiopia has documented widespread rubella infection through the measles-rubella case-based surveillance system, and has not yet introduced rubella vaccine. Methods: a retrospective records review was conducted in four selected tertiary referral hospitals in Ethiopia covering medical records from January 2015 to December 2024, in various clinics likely to identify and characterize CRS cases. Results: the hospital-based retrospective record review identified 1213 suspected cases of congenital rubella syndrome, of which 378 were confirmed by clinical compatibility and 3 by serological laboratory testing. Most of these confirmed cases were identified from clinical records in the years 2021-2024. Congenital heart disease (96%), Hepatomegaly (53%), hepatosplenomegaly (20%) as well as ocular manifestations (16%) were the most common signs among the confirmed CRS cases. Conclusion: this retrospective review has documented the occurrence of CRS in Ethiopia. As Ethiopia prepares to introduce rubella containing vaccine in the next few years, it will be important to strengthen measles-rubella surveillance, utilize the national measles-rubella laboratory for serological confirmation of suspected CRS cases and for genotyping of rubella viruses, and possibly establish sentinel surveillance sites that can help monitor the CRS trends. These measures will be critical to measure the impact of vaccine introduction in the long term.

Abstract Background Sensorineural hearing loss (SNHL) poses a significant public health burden globally, with a disproportionately higher prevalence in developing regions like Africa. The consequences of SNHL in early childhood can be devastating, impacting speech, language, cognitive, and psychosocial development, ultimately affecting educational attainment and quality of life. The etiology of SNHL is multifactorial, encompassing genetic predispositions, prenatal and perinatal complications, infections, ototoxic insults, and environmental factors. In the African context, preventable causes such as congenital rubella, meningitis, mumps, and ototoxic medications play a significant role. Additionally, the high prevalence of consanguineous marriages and the lack of universal newborn hearing screening programs contribute to delayed diagnosis and interventions. Early and accurate diagnosis of SNHL is crucial for timely and appropriate medical, surgical, or audiological (re)habilitative measures. Main body However, the diagnosis of SNHL, particularly in children, can be challenging, necessitating a combination of audiological and radiological evaluations. Audiological assessments; behavioral measures (pure-tone audiometry [PTA]), electroacoustic measures (immittance audiometry and otoacoustic emissions), and electrophysiologic measures (auditory brainstem response and auditory steady-state response) are comprehensive audiological assessments which remain the cornerstone for identifying the site, degree, and laterality of hearing loss. They cannot localize or detect the underlying pathology, and this may affect the determination of appropriate interventions such as hearing aids, cochlear implants, other amplification devices, and other management options. Radiological imaging techniques, particularly computed tomography and magnetic resonance imaging, have revolutionized the evaluation of SNHL by providing detailed visualization of the intricate anatomy and pathologies of the bony and membranous labyrinths, respectively. Conclusion SNHL poses a significant challenge in the African context, with a higher burden and unique etiological patterns. Early and accurate diagnosis, facilitated by the integration of audiological and radiological evaluations, is crucial for timely interventions and optimal outcomes.

PurposeA cross-sectional study was conducted among young female adults aged 18 to 24 years in Bangladesh to assess rubella IgG seropositivity and associated factors.MethodsData were collected on participants’ sociodemographic and family characteristics, residency and age during 2014 Measles-Rubella campaign, and rubella vaccination history. Blood samples were collected and tested for rubella virus-specific immunoglobulin G (IgG) antibodies (rubella IgG) using chemiluminescence immunoassay.ResultsOf the 250 young female adults aged 18–24 years, 87.20% (95% CI: 83.06%–91.34%) were seropositive for rubella IgG: 89.47% among the vaccinated, 85.93% among the non-vaccinated, and 88.54% among those with unknown vaccination history. Seropositivity was not significantly associated with reported rubella vaccination history. Titer levels were significantly higher in seropositive participants without a vaccination history (Median 66.75 IU/mL; interquartile range (IQR): 42.53–98.47) than those with a history (Median 37.30 IU/mL; IQR: 29.70–65.60). Compared with those from rural locations, participants from urban locations had significantly lower odds of seropositivity (Odds Ratio 0.33; 95% CI: 0.12–0.92; p = 0.035).ConclusionA relatively high prevalence of rubella IgG seropositivity was detected. However, approximately one in ten participants remained susceptible to rubella infection during pregnancy and at risk of related adverse outcomes, including congenital rubella syndrome. Seropositivity was not associated with rubella vaccination history suggesting endemic transmission of the rubella virus. The low proportion of participants with a known vaccination history indicates gaps in vaccination documentation. Therefore, well-recorded vaccination histories and strengthened surveillance systems should be developed.

Rates of rubella infection and congenital rubella syndrome decreased significantly since the introduction of the rubella vaccine in 1969. Endemic rubella was declared eliminated in the United States in 2004, and since 2012, all rubella cases in the United States have been associated with infections acquired abroad. With vaccine rates falling worldwide and outbreaks of vaccine preventable diseases increasing, it is important for clinicians to be prepared to recognize and manage diseases they may have never seen before, including rubella. This article reviews the clinical manifestations, complications, diagnosis, management, and prevention of acute rubella infection and congenital rubella syndrome.

Rubella is typically a mild viral illness, but it can lead to severe complications when contracted during pregnancy, such as pregnancy loss or developmental defects in the fetus (congenital rubella syndrome). Therefore, it is crucial to develop and maintain protective immunity in women of childbearing age. In this study, we assessed the transcriptional factors associated with rubella-specific immune outcomes (IgG binding antibody and avidity, neutralizing antibody, and memory B cell ELISpot response) following a third MMR vaccine dose in women of reproductive age to identify key factors/signatures impacting the immune response. We identified baseline (Day 0) and differentially expressed (Day 28–Day 0) genes associated with several RV-specific immune outcomes, including the transferrin receptor 2 (TFR2), which is an important factor regulating iron homeostasis and macrophage functional activity, and a close functional homolog of TFR1, the cellular receptor of the New World hemorrhagic fever arenaviruses. We also identified enriched KEGG pathways, “cell adhesion molecules”, “antigen processing and presentation”, “natural killer cell-mediated cytotoxicity”, and “immune network for IgA production”, relevant to immune response priming and immune activation to be associated with RV-specific immune outcomes. This study provides novel insights into potential biomarkers of rubella-specific immunity in women of childbearing age.

Congenital Rubella Syndrome (CRS) is a collection of symptoms that occur in infants due to rubella virus infection during pregnancy, which can cause heart defects, visual and hearing impairments, and developmental delays. This study aims to describe the implementation of CRS epidemiological surveillance at Prof. Dr. W. Z Johannes Kupang Regional General Hospital. The study was conducted through secondary data analysis and a review of CRS surveillance implementation documents from 2023 to 2025. It was found that 64 CRS cases had been recorded, consisting of 1 definite CRS case, 23 clinical cases, 4 suspects, and 17 discarded cases. Surveillance was carried out in a sentinel manner and supported by an electronic recording system integrated with the Health Office up to the central level. The implementing staff consisted of specialist doctors, public health workers, and midwives. The analysis showed that the strength of surveillance implementation lies in the existence of integrated guidelines and reporting systems. Still, obstacles were faced, such as the unavailability of eye examination equipment, responsible persons who did not comply with the guidelines, and non-routine health promotion. The primary priority issue was the lack of eye examination equipment, which resulted in delays in diagnosis and data collection. As a remedial measure, it is recommended that hospitals immediately procure such equipment and strengthen rubella health promotion. In conclusion, although CRS surveillance at regional hospitals has been well-implemented, optimization of diagnostic facilities and public education is still needed to support the comprehensive elimination of CRS.

Seroprevalence of Immunoglobulin G against measles and rubella over a 12-year period (2009-2021) in Kilifi, Kenya and the impact of the Measles-Rubella (MR) vaccine campaign of 2016.

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: The global fight against rubella and congenital rubella syndrome necessitates effective public health surveillance systems. Digital transformation in rubella surveillance has emerged as a pivotal solution to overcome challenges associated with traditional paper-based reporting methods, including inefficiencies in data collection, delays, and inaccuracies. This scoping review examines global practices, challenges, and opportunities in digital rubella surveillance. Method: A scoping review methodology was employed, guided by the Arksey and O&amp;apos;Malley framework and enhancements from the Joanna Briggs Institute. A systematic search was conducted across databases, including PubMed, Scopus, and the WHO Global Health Library, covering literature from 2010 to 2024. Eighteen studies meeting the inclusion criteria, focusing on digital surveillance tools and practices in rubella monitoring, were synthesised. Data were extracted and analysed thematically to identify common practices, challenges, and opportunities. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The most prominent theme was implementation challenges (50%), particularly data completeness, infrastructure limitations, privacy concerns, and training gaps. Surveillance effectiveness (38.9%) focused on diagnostic accuracy and reporting timeliness. Global practices (33.3%) highlighted mobile apps, EMRs, GIS, and DHIS2 use, with varied adoption across income settings. Opportunities (16.7%) included AI integration, age-structured data strategies, and cross-border collaborations to enhance CRS prevention and surveillance system performance.&amp;lt;i&amp;gt; Conclusion&amp;lt;/i&amp;gt;: Digital transformation holds transformative potential for rubella surveillance, offering scalable and cost-effective solutions to address existing gaps. Policymakers and stakeholders must prioritise investments in digital infrastructure, training, and regulatory frameworks to optimise these systems and support rubella elimination goals.

Congenital Rubella Syndrome (CRS) is a condition that results from maternal rubella infection during pregnancy, particularly in the first trimester. This infection can lead to a variety of clinical manifestations in the infant. The virus can cross the placenta and affect fetal development, leading to a range of birth defects. Because of this risk, rubella infection during pregnancy is a major public health concern. Globally, around 236,000 cases of Congenital Rubella Syndrome (CRS) occur each year in developing countries, with Indonesia reporting a rise in incidence from 3.2 in 2015 to 5.6 per 100,000 in 2017. The risk of CRS is 85% when infection occurs within 12 weeks of gestation and may cause severe congenital defects, including congenital heart defects, cataracts, intrauterine growth retardation with sensorineural hearing loss (SNHL) being the most prevalent. It may be unilateral or bilateral and is often not detected until delays in language development become apparent. SNHL in children impairs speech and language development if untreated, necessitating early intervention. Therefore, newborn hearing screening is essential in infants with suspected or confirmed CRS. Rubella-induced damage to the cochlea and auditory nerve underlies SNHL, diagnosed through audiological assessments like otoacoustic emissions (OAE), brainstem evoked response audiometry (BERA), and auditory steady-state response (ASSR). Management involves hearing aids, cochlear implants, and speech therapy, with early intervention by 6 months critical to optimize outcomes. Prevention relies on MMR vaccination and universal newborn hearing screening, particularly in resource-limited settings like Indonesia, where enhanced immunization and screening access are essential to reduce CRS burden.