Congenital measles — when a baby contracts the virus in utero from the mother — has been making headlines since the Pennsylvania Department of Health (DOH) on Oct. 19 issued a health alert warning doctors about an increase in measles cases during pregnancy.
DOH’s alert provided clinical guidance on how healthcare providers can identify and treat measles in pregnant women and newborns.
The day after Pennsylvania released its alert, media outlets including NBC News reported that the U.S. historically rarely, if ever, sees cases of congenital measles. But now that appears to be changing. At least six babies in Pennsylvania have been born with measles so far this year, Pennsylvania doctors told NBC.
Pennsylvania health officials stress that the best way to prevent congenital measles is for the mother to get the measles-mumps-rubella (MMR) vaccine before pregnancy.
“Getting vaccinated before becoming pregnant is the best way to prevent measles and newborn measles,” the DOH said in an Oct. 19 press release. “The MMR vaccine should not be administered during pregnancy and pregnancy should be avoided for 28 days after receiving the MMR vaccine.”
However, doctors who spoke with The Defender said that decades of studies have shown that vaccine-induced measles immunity is weaker and fades faster than natural immunity — so women who had a natural measles infection as a child are better protected against giving birth to a baby with congenital measles than women who got the MMR vaccine.
“For the first time in a generation, American babies are being born infected with measles and the science told us this was coming,” said Michelle Perro, a pediatrician. “The vaccine program didn’t eliminate measles — it shifted the risk to the most vulnerable: newborns and the pregnant women carrying them.”
Dr. Ben Edwards, an integrative medicine family practitioner who successfully treated over 300 cases of measles during the West Texas measles outbreak and runs a private practice serving roughly 2,000 patients, said that before the MMR vaccine, measles was a “routine childhood illness” in which over 99% of children overcame it with “no problem, resulting in robust, permanent and life-long immunity.”
During that era, “practically all pregnant mothers had measles in their youth,” he said. The mothers passed along protective antibodies to their babies in the womb, which protected the babies during the “more vulnerable first year of life.”
As the baby grew up and the level of maternal antibodies faded, the child would get measles sometime in the first decades of life and develop its own robust, lifelong immunity.
“It’s really a beautifully designed natural immunization process — but we’ve lost that because of the measles vaccine program,” Edwards said.
Children’s Health Defense (CHD) Senior Research Scientist Karl Jablonowski agreed. “The natural course of measles pre-vaccine was to infect practically every immunologically-naive school-aged child every two years, imparting life-long immunity.”
The measles vaccine wiped out that natural cycle and brought with it inferior protection compared to naturally acquired protection, Jablonowski said.
The American Academy of Pediatrics (AAP) acknowledges that congenital measles was exceedingly rare before the introduction of the MMR vaccine. On Sept. 8, the AAP published new guidance on congenital measles so that doctors know how to identify and treat it.
“Many providers who have never seen measles except in textbooks are now having to learn what to do, how to look out for measles in their patients and how to manage them,” said Dr. Pia S. Pannaraj, a member of the AAP Committee on Infectious Diseases and professor of pediatrics at the University of California, San Diego.
The AAP defines congenital measles as an infection acquired before birth in which a newborn tests positive for measles or develops symptoms within the first 10 days of life.
If a pregnant woman gets measles, there’s about a 25%-30% chance she will transmit the virus to her baby, the AAP said.
A congenital measles infection is typically confirmed via clinical or laboratory testing. It’s different from neonatal measles, in which babies contract the virus after birth from close contact with people who have measles.
The rule of thumb is that if the baby develops a measles rash 10 days or more after birth, it’s likely neonatal measles. If the rash develops less than 10 days after birth, it’s likely congenital measles, the AAP said.
There is no national database on congenital measles, “likely because the disease hasn’t been routinely seen in the United States for decades,” the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) reported.
“The same institutions that assured us measles was gone are now scrambling to count cases of a disease they never built a surveillance system for,” Perro said. “That’s a policy failure and babies are paying the price.”
