WHEN maternal rubella occurs during the first trimester of pregnancy, rubella virus can be detected in products of conception, in the fetus throughout pregnancy, and in the infant for several months after birth. 1 Further, sera from children with the congenital rubella syndrome have been found to contain rubella neutralizing antibody in high titers. 2 Although these data clearly show that a state of immunologic tolerance does not exist, it is not known if the elevated levels of neutralizing antibody in the younger infant represent de novo synthesis of antibody by the infant or the transplacental transfer of maternal antibody. Following epidemic rubella occurring in the United States during the winter and spring of 1964, congenital rubella was observed in several centers. The neonatal syndrome consists of congenital heart disease, cataracts, hepatosplenomegaly, and thrombocytopenic purpura. It is the purpose of this report to present the significant clinical, hematologic, virologic, pathologic,
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