BACKGROUND:
In 2003, one case of congenital rubella syndrome (CRS) was identified in New York City (NYC). This was the only case reported in the United States for that year.

OBJECTIVE:
To determine whether there is evidence of ongoing rubella transmission in NYC by identifying unreported cases of CRS from 1999 –2002.

METHOD:
A retrospective search of hospital discharges with CRS-related ICD-9 codes among children < 12 months of age using the SPARCS dataset was conducted. Follow up of children with compatible diagnoses was conducted to determine if the case met criteria for a possible CRS case. Facilities where CRS cases would be referred were contacted to identify additional evidence of rubella transmission.

RESULT:
Among the 102 records identified as having ICD-9 codes consistent with CRS (771.0: Congenital Rubella; 743.3: Cataracts; 389.1: Deafness; 745.5/747: Congenital Heart Disease; 742.1: Microcephaly and 759.89: Dermal Erythropoiesis);, 3 infants were identified as having the CRS code. Further investigation of these cases revealed that 1 was imported from Haiti, 1 was a New Jersey case and 1 was IgM negative. Further investigation of the remaining 99 records has revealed no additional cases of CRS. No additional cases of CRS were identified by phone calls to major hospitals and agencies that would care for CRS patients.

CONCLUSION:
No additional unreported NYC CRS cases were identified. This suggests that there is no ongoing endemic rubella transmission. CRS cases would be detected by the current surveillance system.

LEARNING OBJECTIVES:
Methods to evaluate surveillance systems are discussed focusing on use of hospital discharge datasets.