IntroductionIn line with the regional aim of eliminating rubella and congenital rubella syndrome (CRS), phased introduction of rubella-containing vaccines (RCV) in the Philippines’ routine immunization programme began in 2010. We estimated the burden of CRS in the country before widespread nationwide programmatic RCV use.MethodsWe performed a retrospective chart review in four tertiary hospitals. Children born between 1 January 2009 and 31 December 2014 and identified as possible CRS cases based on the presence of one or more potential manifestations of CRS documented in hospital or clinic charts were reviewed. Cases that met the clinical case definition of CRS were classified as either confirmed (with laboratory confirmation) or probable (without laboratory confirmation). Cases that did not fulfil the criteria for either confirmed or probable CRS were excluded from the analysis.ResultsWe identified 18 confirmed and 201 probable cases in this review. Depending on the hospital, the estimated incidence of CRS ranged from 30 to 233 cases per 100 000 live births. The estimated national burden of CRS was 20 to 31 cases per 100 000 annually.DiscussionThis is the first attempt to assess the national CRS burden using in-country hospital data in the Philippines. Prospective surveillance for CRS and further strengthening of the ongoing measles-rubella surveillance are necessary to establish accurate estimates of the burden of CRS and the impact of programmatic RCV use in the future.

INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (COVID 19), also known as COVID 19, was first detected in 2019 as a result of a cluster of pneumonia cases in China. It is known to cause respiratory illness in a majority of cases, however myocardial involvement can be seen in 7% of cases, with even a smaller number in pediatric populations. CASE PRESENTATION We are presented with a 14 year old male with confirmed COVID 19 infection that is followed by a fulminant myocarditis resulting in High grade AV Block and subsequent pacemaker insertion, which is the first reported case in the pediatric population. DISCUSSION Cardiac injury resulting from a recent COVID 19 infection can result to a fulminant myocarditis. This can present as arrhythmia, seen in 16.7% of cases. The mainstay of treatment is still maintaining hemodynamic stability and initiating immunomodulatory support, however, specifically in this case resulting in third-degree AV block, pacemaker insertion may also be required. CONCLUSION Although severe cardiac involvement in COVID 19 infection is rare, a fulminant myocarditis is possible for some patients. KEYWORDS COVID 19, Myocarditis, pacemaker, arrhythmia