Pennsylvania warns doctors of rise in measles in pregnancy and congenital measles

The Pennsylvania Department of Health issued an alert Monday to doctors about an increase in measles infections in pregnant women, as well as a rise in congenital measles, a disease that is rarely, if ever, seen in the U.S., NBC News reported. The Hill reported that the alert said congenital measles, a measles infection in a newborn contracted from the mother, was identified "for the first time in decades." [ 2 , 3 ]

The department said that 66 pregnant women in Pennsylvania had been diagnosed with measles since the state's outbreak began in April. "Getting measles while pregnant increases the risk of miscarriage, early labor, and low birth weight," a department spokesperson said in an email. It is unclear how many women have miscarried or delivered babies with congenital measles. The department said state law prohibits it from releasing details of the outcomes of those pregnancies, and there is no national database that tracks cases. NBC News said true numbers may also be obscured because the outbreak has largely been limited to Amish families who do not always seek conventional medical assistance. [ 2 ]

Anecdotally, doctors have said that at least six babies were born in Pennsylvania with congenital measles. NBC News reported that babies can have a range of symptoms, from a rash and fever to pneumonia, neurological problems and low blood platelets. At least two developed pneumonia and were admitted to an intensive care unit, doctors said. The Hill said babies who contract measles before or during birth can become very sick and are at risk of health complications later in life. Ars Technica said congenital measles can be fatal and survivors require monitoring for years. [ 1 , 2 , 3 ]

NBC News reported that as of Thursday there have been 4,410 measles cases in the U.S. this year, and 1,286 cases in Pennsylvania as of Monday. The Hill reported more than 1,200 cases in Pennsylvania, and said the health department has confirmed five deaths, though a sixth death was reported earlier this month in Franklin County. [ 2 , 3 ]

The American Academy of Pediatrics (AAP) added a "frequently asked questions" page about congenital measles to its website in September in response to ongoing and increasing outbreaks. According to the AAP, only infections in the last two weeks of pregnancy or the first 10 days after delivery are considered congenital, and an estimated 25 percent to 30 percent of babies whose mothers have a measles infection at birth are also infected. Few pediatricians have treated a newborn with congenital measles, The Hill reported. [ 2 , 3 ]

Congenital measles was uncommon in the U.S. before the measles vaccine was introduced in the early 1960s because most women had been infected as children, according to The Hill. NBC News said it is emerging as a threat now as outbreaks increase and vaccination rates fall. In its alert, the department urged women to get the measles, mumps, rubella (MMR) vaccine before pregnancy. MMR is not recommended once pregnancy begins because it is a live virus vaccine, The Hill reported. [ 2 , 3 ]