By Kirstie Perrotta, MPH, MotherToBaby California
As if pregnant women don’t have enough to worry about, a once eradicated infectious disease is back and making headlines: Measles. Not even half way through 2019, the Centers for Disease Control and Prevention (CDC) recently announced that the number of measles cases in the United States (U.S.) has surpassed 700, the highest number ever reported since the disease was eliminated from this country in 2000. Cases have been reported in states across the U.S., and current outbreaks are occurring in New York, New Jersey, Michigan, California, Georgia, and Maryland.
Here at MotherToBaby, we get lots of questions about infections in pregnancy – Zika virus, varicella (chicken pox), cytomegalovirus (CMV), and influenza (the flu) to name just a few. So when I received a call from Meghan yesterday, and her question was about measles, I was happy to help. Meghan quickly filled me in on what had happened. She lived in Los Angeles, was 20 weeks pregnant, and had visited a Home Depot on Saturday where a case of measles had been reported.
It’s understandable that Meghan would be concerned. Measles is highly contagious. According to the CDC, “measles virus can live for up to two hours in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.”
Symptoms of measles generally appear about 7 to 14 days after a person is infected, and can include high fever, rash, cough, runny nose, and red watery eyes. The symptoms of measles can be unpleasant, but even more daunting is the possibility of rare complications. For every 1,000 children who get measles, one will develop encephalitis (swelling of the brain) that can lead to convulsions (seizures) and cause deafness (hearing loss) or intellectual disability, and 1-2 children out of every 1,000 who get measles will die from it. In 2017 alone, global estimates show that 110,000 people (mostly children) died from measles.
To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, research suggests that measles infection can be associated with an increased risk for miscarriage, premature delivery (having the baby before 37 weeks), and stillbirth. If a pregnant woman is infected with the measles at the time of delivery, the baby can be born with a congenital measles infection, which can lead to death.
The first question I asked Meghan was if she had ever received the Measles, Mumps, and Rubella (MMR) vaccine. Just one dose is about 93% effective at preventing measles, while two doses is about 97% effective, so it’s the best way to protect yourself against this disease. These vaccines are routinely given in childhood, so Meghan couldn’t remember if she had received both, but after texting her mom she was able to confirm that she was fully vaccinated. Whew, that was good news. Next we looked into when exactly Meghan had visited the Home Depot in LA. Turns out it was the day after the individual with measles had been there. More good news since measles can only stick around for about 2 hours after the infected individual has left the area. Together, we determined that is was very unlikely Meghan has been exposed to the measles virus, and her baby would not experience any measles-related complications.
So, what’s the best thing you can do today to make sure you are protected like Meghan?
Pre-Conception Women: Women who are planning a pregnancy in the future should make sure they are up to date with their MMR vaccine BEFORE they get pregnant. If you can’t find your vaccine record, call your doctor who may know. If they don’t have a record, a blood test (titer) can be done to determine if you have immunity to measles. If it turns out you are not immune, you’ll want to get the MMR vaccine as soon as possible. Just make sure you wait at least one month after getting the shot before attempting to get pregnant.
Pregnant Women: Because pregnant women can’t receive live vaccines (like MMR), the best thing you can focus on during pregnancy is prevention. Good hand washing is always a good idea. If there is a confirmed measles outbreak in your city, consider avoiding crowded public places, and definitely steer clear of any locations that have been identified as a known risk.
Breastfeeding Women: Once you are no longer pregnant, the MMR vaccine is again an option. So check your immunity status and get up to date with any needed vaccines. The CDC considers the MMR vaccine compatible with breastfeeding.
If you have any questions about measles infection or the MMR vaccine during pregnancy or while breastfeeding, MotherToBaby is here to help. Don’t hesitate to give us a call at 866-626-6847, text, or chat with one of our information specialists today.
Kirstie Perrotta, MPH, is a Teratogen Information Specialist at MotherToBaby California. In addition to counseling on both the phone and chat, she is part of MotherToBaby’s Zika Task Force and co-chair of the Education Committee. Kirstie received her Master of Public Health (MPH) from the University of San Francisco in 2013, and has worked in the field of reproductive health for over 6 years. She thoroughly enjoys the opportunity to educate pregnant and breastfeeding women on a daily basis.
MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.