American Annals of the Deaf

Relationship of Rubella, Herpes Simplex, Cytomegalovirus, and Certain Other Viral Disabilities McCay Vernon and Doin Hicks Gallaudet College Current medical research is yielding rather startling findings on the effects of prenatal rubella on deaf adolescents and on the relationship of certain viral diseases to hearing loss. The purpose of this paper is to present an overview of this literature with an emphasis on its implications for professionals who work with hearing-impaired children and adults. The data describe both the serious pathology recently discovered to be present in some rubella deafened youth and the potential dangers of several other viruses. The emphasis is on pathology in order that disabilities will be identified and treated or else prevented. In order that undue alarm be avoided, it is important to note that many persons having the viral diseases discussed will often give birth to children who have no physical handicaps. Corollary to this, many youth deafened by rubella have no other disorders. For example, during the late sixties a group of 34 deaf rubella preschool children were followed carefully for a period of 4 years. This research (Hicks, 1970) demonstrated few major differences between the rubella group and a comparison sample of nonrubella deaf children. Measures of intelligence and learning potential for the rubella group appeared within normal limits, thus establishing a good prognosis for their future success in school. A tendency toward distractibility and hyperactivity in the rubella group constituted the only significant, observable behavior difference. RUBELLA Rubella should be of utmost concern to people working in deafness related professions today. This concern is justified by the realization that in 1982, '83, and '84 there will be a huge number of rubella youths reaching 19 years of age. They will be entering vocational rehabilitation service programs or beginning postsecondary education during these years. For example, in 1983 there will be a 158% increase in the number of 19 year olds. Instead of the usual 2,800, there will be an estimated 7,232 (Stuckless, 1979). This large "bulge" of deaf youth is a product of the 1963-1965 rubella epidemic. If parents and professionals do not implement planning and programming now to assure that rehabilitation and education programs are prepared to serve these young people, it will mean that they will not receive the job training and other rehabilitation needed. Medical Aspects Most people know rubella as the 3-day measles, a relatively harmless rash and fever. However, it is potentially far more serious. When the disease strikes a pregnant woman, the virus frequently attacks the developing fetus. This occurs at a time in life when fetal cells are rapidly multiplying to form organs and other body parts, e.g., the auditory mechanisms . The virus reduces the rate of this cell division, causes cells to die prematurely, and makes others grow imperfectly (Barr, Mullin, & Kenzik, 1978; Harris, 1979; Ziring, 1977, 1978). Thus, those parts of the body which are developing during the time the virus is present and active are frequently damaged. With certain organs such as the heart or ear, the period of development is fairly specific (Ziring, 1977, 1978). A.A.D. I August 1980 529 Rubella and Other Viral Disabilities Usually these organs will be severely affected only if the virus attacks during the time they are forming. However, in the case of the nervous system and many other parts of the body, development occurs throughout gestation and continues until adulthood. Thus, the presence of the rubella virus has a "shot gun" effect on these kinds of tissues, especially those of the central nervous system (Buimovici-Klein, Lang, Ziring, & Cooper, 1979). Once the rubella infection starts in a fetus it continues throughout gestation and usually for 6-18 months after birth (Harris, 1979; Ziring, 1977,1978). Sometimes it remains alive and active in the body much longer. One case is reported in which a woman who contracted rubella prenatally continued to be infected until age 29 (Ziring, 1978). In situations such as this when the virus continues to grow slowly in certain tissues, there is danger of a multitude of additional serious late-appearing physical defects (Ziring, 1978). Another medical issue which should be mentioned is that of...