‘New forms of measles’ emerge in Pennsylvania as cases surge

Key Points:

• Pennsylvania is experiencing a severe measles outbreak, with hundreds infected, numerous hospitalizations, and four deaths, including cases of congenital measles where mothers transmit the virus to newborns during pregnancy or birth.
• Congenital measles, once rare due to widespread childhood immunity and vaccination, is reemerging as vaccination rates decline and fewer young adults have natural immunity, leading to serious complications such as pneumonia, encephalitis, and even death in newborns.
• Measles during pregnancy increases risks of pregnancy loss, premature delivery, low birth weight, and congenital infection, with potential long-term effects like subacute sclerosing panencephalitis (SSPE), a fatal neurological disorder.
• The American Academy of Pediatrics has issued guidance to help doctors manage congenital measles, addressing a knowledge gap as few pediatricians have experience treating newborns with the infection.
• Pregnant women who are not immune to measles are at higher risk and should verify their immunity status with healthcare providers; while the MMR vaccine is contraindicated during pregnancy, nonimmune women should be vaccinated before or after pregnancy, and exposed pregnant women should seek immediate medical care for possible immune globulin treatment.