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Pennsylvania Sees Rise in Congenital Measles Cases
Confirmed
In Short: Pennsylvania's health department issued a health alert Monday, warning of an increase in measles cases among pregnant individuals and the subsequent rise in congenital measles cases, which have not been seen in decades.
As of October 19, Pennsylvania had reported 1,286 measles cases this year across 42 counties, with at least 53 cases occurring during pregnancy.
The alert noted that pregnant individuals who have not been vaccinated against measles or previously had the infection are particularly susceptible.
At least one case of congenital measles has led to a newborn's death, highlighting the severity of the issue.
The Pennsylvania Department of Health confirmed that 66 of the state's measles cases were in pregnant women, though it does not keep a specific tally of congenital measles cases due to the lack of a standardized definition.
The department's advisory included detailed clinical guidance for managing measles exposures and cases during pregnancy as well as in newborns.
The outbreak has resulted in 943 confirmed cases of measles across 39 counties in Pennsylvania, making it the largest outbreak of the virus in the U.S. this year.
There have been 943 confirmed cases of measles across 39 counties in Pennsylvania, with about 176 people hospitalized.
The CDC has recognized only two deaths associated with measles this year, although it hasn't identified the states or timing.
The Pennsylvania Department of Health reported the death of an unvaccinated resident of Lancaster County who tested positive for measles, marking the fifth measles-associated death in the state since August.
The department noted that getting measles while pregnant increases the risk of miscarriage, early labor, and low birth weight.
The American Academy of Pediatrics added a 'frequently asked questions' page about congenital measles to its website in response to ongoing and increasing measles outbreaks.
One father in Lancaster County told NBC News that his wife was sick with measles in August and went into labor a month early.
What this adds
The outbreak highlights the resurgence of measles as vaccination rates fall.
The definition of congenital measles is tight, only including infections that occur in the last two weeks of pregnancy or the first 10 days post-delivery.
What's confirmed
- Pennsylvania’s health department issued a health alert Monday as cases of measles in pregnancy and, in turn, cases of congenital measles have continued to increase.
- At least six babies have been born with congenital measles in the state.
- Congenital measles can lead to serious health issues for newborns, including brain inflammation and death, according to a recently published fact sheet from the American Academy of Pediatrics.
What's still developing
- Congenital measles can be fatal, and survivors require monitoring for years.
- Many doctors have never seen such cases in their careers given the decades of successful use of the measles, mumps, and rubella (MMR) vaccine.
- But Ratner cited a 2021 case series in France described asymptomatic infants who tested positive for measles more than 20 weeks after maternal infection.
- Furthermore, the case definition for congenital measles is tight: Only measles infections that occur in the last two weeks of pregnancy or the first 10 days post-delivery are considered congenital.
- It’s only now emerging as a threat as measles outbreaks are increasing as vaccination rates fall.
- In 2000, the United States eliminated continuous, local transmission of measles, an achievement built upon widespread vaccination.
- "It was virtually unheard of for someone to reach childbearing age and not have been naturally infected with measles," the Children's Hospital of Philadelphia's noted last month.
- An estimated 25% to 30% of babies born to mothers with measles at delivery are also infected, CIDRAP reported.
- Congenital measles also raises the risk of encephalitis (swelling of the brain) and subacute sclerosing panencephalitis, or SSPE, a progressive brain disease that Ratner said is "essentially invariably fatal."