During CRS, IL-1 is produced many hours before IL-6, and because IL-1 induces the secretion of IL-6 and soluble IL-6 receptor (sIL-6R), the release of IL-1 from monocytes and macrophages in the peripheral circulation has been hypothesized to be the initiating event in CRS34. Here, IL6 is linked to congenital rubella syndrome.