THE EPIDEMIC of rubella during the spring of 1964 was one of the largest ever recorded in the United States.1 Rubella has been a reportable disease in New York City for more than three decades. The annual incidence has usually ranged between 1,000 and 3,000; in 1964 more than 20,000 cases were reported.2 In the wake of this epidemic more than 200 infants with congenital malformations were referred to us for study. An agent with the characteristics of rubella virus was isolated from approximately one half of these infants.
An unusual feature of the epidemic was the high incidence of thrombocytopenic purpura observed during the neonatal period. In the past, this condition was not considered to be a typical manifestation of the rubella syndrome. Although scattered reports of congenital rubella with purpura are recorded in the literature,3-9 evidence that this was a rubella-associated condition was documented by