State issues alert to doctors
The Pennsylvania Department of Health sent an alert to physicians on Monday about a rise in measles infections among pregnant women and a worrying increase in congenital measles. The condition is rarely, if ever, seen in the United States, according to NBC News.
The department said 66 pregnant women in the state have been diagnosed with measles since the outbreak began in April. A department spokesperson said in an email that "getting measles while pregnant increases the risk of miscarriage, early labor, and low birth weight."
What is known about affected newborns
It is unclear how many of those women have miscarried or delivered babies with congenital measles. The health department said state law bars it from releasing details of pregnancy outcomes, and no national database tracks such cases. The true numbers may also be hidden because the outbreak has largely been confined to Amish families, who do not always seek conventional medical care, according to NBC News.
Anecdotally, doctors have said at least six babies have been born in Pennsylvania with congenital measles. Symptoms can range from rash and fever to pneumonia, neurological problems and low blood platelets. Doctors said at least two of the infants developed pneumonia and were admitted to an intensive care unit.
The condition can be fatal. A Lancaster County father previously told NBC News that his wife had measles in August and went into labor a month early, and that their baby died shortly after birth.
Long-term risks and the wider outbreak
The state health department said congenital measles can also cause severe brain and immune system problems later in life. One possible complication is subacute sclerosing panencephalitis, or SSPE, a very rare and severe inflammatory brain condition that is almost always fatal. It typically appears seven to 10 years after a measles infection, though there is evidence it may occur earlier in children born with congenital measles.
Nationally, there have been 4,410 measles cases this year as of Thursday, according to the report. Pennsylvania had recorded 1,286 cases as of Monday.
Congenital measles was rare even before widespread vaccination because most women had been infected as children and were already immune. It is emerging as a threat now as outbreaks grow and vaccination rates fall. Last month, the American Academy of Pediatrics added a frequently asked questions page on the topic to its website. According to the AAP, the condition occurs in newborns whose mothers were infected in the two weeks before birth and who test positive or develop symptoms within 10 days of delivery.
Prevention and treatment
There is no specific treatment for congenital measles beyond supportive care such as fluids, hydration and supplemental oxygen. The health department said the best way to prevent it is for women to be vaccinated before becoming pregnant.
Pregnant women cannot receive the measles vaccine because it contains a weakened but live virus. Unvaccinated pregnant women who are exposed can receive immunoglobulin within six days of exposure, which the department said can "provide protection against measles infection or reduce the risk of serious illness among susceptible people."
State health officials said the vaccine can be given after delivery and is safe for breastfeeding mothers.
