Measles outbreak holds higher risk for pregnant women, babies

(CNN) — A newborn with measles is among the cases reported in the growing West Texas outbreak, Lubbock public health officials say. Experts say the case serves as a reminder that the disease can be especially dangerous for pregnant women and very young children.

“This is how widespread this epidemic is, that it’s even showing up in unvaccinated pregnant women,” said Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine.

At least two pregnant women have been infected in this outbreak, according to officials at Covenant Hospital in Lubbock. Eighty-one measles cases have been reported in children ages 4 and younger across Texas and New Mexico. This is part of the larger outbreak that now spans three states, including Oklahoma, and totals 258 reported cases.

The infant, who has recovered, was born to an unvaccinated mother who was recently infected with the virus, according to Katherine Wells, director of Lubbock Public Health.

Measles and pregnancy

Measles is a highly contagious airborne illness that can cause a rash, fever, red eyes and cough. Severe cases can result in blindness, pneumonia or encephalitis, swelling of the brain. In some cases, the illness can be fatal.

Both newborns and pregnant women are at higher risk of complications from the measles virus.

Unvaccinated mothers who get measles earlier in pregnancy risk low birth weight, premature birth and still birth.

For those who get the infection later in pregnancy, there is a higher chance of passing the infection to the baby through vertical transmission – in which the virus passes through the placenta – or, more commonly, through airborne transmission right after birth.

When their mothers have immunity against measles, babies younger than 6 months will have some immunity via her antibodies. But if a mother is unvaccinated or doesn’t have immunity, babies are left susceptible.

“Neonates have a more fragile immune system, and their recovery could be more complicated,” says Dr. Lynn Yee, professor of obstetrics and gynecology at the Northwestern Feinberg School of Medicine.

Pregnant women who are unvaccinated are themselves at higher risk of measles complications, such as pneumonia.

People who aren’t pregnant can receive the measles-mumps-rubella vaccine up to 72 hours after being exposed to the virus, to prevent infection. But pregnant women cannot get the vaccine; instead, they can receive immunoglobulin, or antibodies, up to six days after a measles exposure. Infants younger than 6 months can receive immunoglobulin after exposure, too.

Yee has never treated a patient with measles, but she has counseled pregnant women who were exposed to the virus but who hadn’t been vaccinated as children because of their parents’ wishes.

“I think most patients want to protect themselves, and perhaps there is some feeling of maybe regret or anger that they weren’t better protected,” she said.

Vaccine protects against more than measles

Although measles poses severe health risks, doctors are generally more concerned with how the viral infection rubella can affect newborns.

“Women who are not vaccinated against measles are also not vaccinated against rubella,” noted Dr. William Moss, a pediatrician who directs of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. “Thus, these women are also at risk of having a baby with congenital rubella syndrome should they acquire rubella in the first trimester of pregnancy.”

Among women who are infected with rubella early in pregnancy, there’s a 90% chance the baby will have congenital rubella syndrome. This can cause developmental delays, heart defects, deafness and cataracts. According to the CDC, 1 in 3 babies with congenital rubella syndrome will die before their first birthday. There is less risk when the infection occurs after 20 weeks of pregnancy.

Rubella was once common and widespread in the United States, but was eliminated in the US in 2004. The CDC says fewer than 10 people in the US are reported to have rubella each year and they’re mostly linked to travel outside the country.

The MMR vaccine is highly safe and effective, according to experts. One dose confers 93% immunity against measles and 97% against rubella. With the second dose, measles immunity rises to 97%, too.

“The most important thing you can do is … to get vaccinated,” Yee said. “Vaccines work. …This is preventable. This should not be happening.”

CNN’s Brenda Goodman contributed to this report.

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