The Pennsylvania Department of Health issued a health alert Monday as cases of measles in pregnancy and, in turn, cases of congenital measles continued to rise. Before the current outbreak — which continues to ripple across the state — congenital measles cases had not been seen in decades, the department noted in its advisory.
The alert includes detailed clinical guidance for the management of measles exposures in cases during pregnancy as well as cases in newborns. Many doctors have never seen such cases in their career, because of the decades of successful use of the measles, mumps and rubella (MMR) vaccine. But now, with vaccination rates slipping across the country, the highly contagious virus is better able to gain a foothold in communities and spread quickly through under-vaccinated pockets, as is happening in Pennsylvania.
As of Oct. 19, Pennsylvania had reported 1,286 measles cases in 42 counties this year. Of those, 247 have been hospitalized, and six people have died (although the last reported death is still pending an investigation by the state health department before being added to the state count).
The Pennsylvania Department of Health did not immediately respond to a request for information from Ars Technica. But reporting from the 19th earlier this month put the number of measles cases during pregnancy at 53. At least one case of congenital measles resulted in death; the first death reported in the current outbreak was in a newborn baby who died immediately after birth while his mother was seriously ill with measles.
risk infection
Pregnant people who have not been vaccinated against measles or have previously had the infection are susceptible. A case of measles during pregnancy increases the risk of hospitalization, pneumonia, the need for oxygen support or mechanical ventilation, and death. It also increases the risk of miscarriage, stillbirth, low birth weight, and premature labor. The MMR vaccine is not recommended during pregnancy because it is a live-attenuated vaccine and there is a theoretical risk of causing an infection in a fetus. If a pregnant person is exposed to the virus, they are recommended to receive intravenous immunoglobulin to protect against infection – but only if it is given within six days of exposure.