Congenital measles identified for first time in decades: What you need to know

PENNSYLVANIA - As the measles outbreak continues to surge nationwide, health officials are tracking an increase in measles cases during pregnancy, along with rising concerns about congenital measles.

The Pennsylvania Health Department recently issued a health advisory for the severe newborn condition, which they say has been identified "for the first time in decades."

Risks to the mother and baby

Why you should care:

Measles is a vaccine-preventable respiratory illness that is highly contagious. When contracted during pregnancy, measles is associated with an increased risk of hospitalization, pneumonia, the need for oxygen support or mechanical ventilation, and death.

Maternal infection during pregnancy also carries significant risks for the baby, which include:

• An increased risk of miscarriage
• An increased risk of stillbirth
• Low birth weight
• Preterm labor

Understanding congenital measles 

Dig deeper:

Babies can develop congenital measles if the virus is passed to them in the womb. A newborn is at risk of not only getting sick, but also spreading the virus, if they are born anytime between when the mother first starts showing symptoms and about two weeks after her rash appears.

How congenital measles affects a newborn can look very different from baby to baby. While some newborns might not show any signs of being sick, others might have a mild illness, and in the worst cases, it can turn into a fast-moving, life-threatening disease. Some of the symptoms include:

• Fever
• Jaundice
• Blotchy measles rash
• Thrombocytopenia
• Pneumonia
• Neurologic complication

Long-term health complications 

What's next:

Health officials say all babies born to mothers who had measles during pregnancy are at risk for delayed complications.

• Subacute sclerosing panencephalitis (SSPE): This is a delayed complication that can occur months or years after an apparent full recovery. Families are advised to monitor for neurological signs later in life, including seizures, regression in milestones, and academic difficulties in older children.
• Immune amnesia: Another consequence of a measles infection is immune amnesia. This is a form of immunosuppression that can last for months to years following an acute infection, increasing susceptibility to other serious infections.

Prevention and postexposure care 

What you can do:

When it comes to preventing measles and protecting your baby, health officials offer specific guidelines depending on where you are in your pregnancy:

• Before pregnancy: Getting the MMR vaccine before you conceive is the best way to prevent measles and congenital measles. Because it is a live vaccine, it cannot be given during pregnancy, and you should wait at least 28 days after getting the shot before trying to become pregnant.
• During pregnancy: If you are pregnant, not immune, and exposed to measles, you should receive intravenous immunoglobulin (IVIG) within six days of exposure. This treatment lowers your chances of getting infected and reduces the severity of the illness if you do get sick.
• After delivery: If you recently gave birth and are not immune, getting the MMR vaccine right away protects you from infection and lowers the risk of exposing your newborn.
• While breastfeeding: The MMR vaccine is completely safe for nursing mothers. Breastfeeding does not interfere with building immunity, and the vaccine virus cannot be passed to your baby through breast milk.