Early elevated serum levels of multiple cytokines, including interleukins IL-6, IL-8, and IL-10, monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein-1β (MIP-1β), and interferon-g (IFN-g), can be associated with the development of severe CRS [56]. Here, CCL4 is linked to congenital rubella syndrome.