Infectious diseases are a primary cause of hearing impairment and produce about 25% of profound losses. Of these, one fifth are congenital. The major infections include rubella, cytomegalovirus, measles, pertussis, meningitis, and acute otitis media. Hearing loss from ototoxicity is also observed with a number of drugs, notably the aminoglycosides, loop diuretics, and cisplatin. Preventive measures are defined according to primary, secondary, and tertiary principles. Three principles of prevention are considered: direct action, defined objectives, and the variability of effective prevention according to cause.
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