Measles, also known as rubeola, is a highly contagious viral illness. Vaccination rates have decreased over the past decade, so the incidence of measles has increased, with recent outbreaks in the Pacific Northwest and New York City.
Measles infections during pregnancy do not cause birth defects, but pregnant women and newborns are more susceptible to medical complications from measles than the general population. These complications include pneumonia and hospitalization. Measles infections during pregnancy may also cause miscarriage, stillbirth, low birth weight, and an increased risk of preterm delivery.
So how can you protect yourself and your unborn child from the measles virus? We answer some frequently asked questions about measles during pregnancy.
How is measles transmitted, and what are the most common signs and symptoms of measles infection?
The virus is highly contagious and lives in the nose and throat mucus of an infected person. It is often spread from person to person through coughing and sneezing, and may remain airborne and infectious for up to two hours. This means, that if you enter a room where a person infected with measles coughed or sneezed up to two hours before you arrived, you still could contract the illness just by breathing the air in the room. When a person has measles, he or she is contagious from four days before until four days after the appearance of a rash.
The most common symptoms of measles are fever, fatigue, cough, runny nose, itchy or red eyes, Koplik spots (white lesions on the inner cheek), and a raised rash. It can take between seven and 21 days from the time you are exposed to the measles virus before symptoms of the illness appear.
How do I know if I’m immune to measles infection?
If you have received at least one dose of the measles-mumps-rubella (MMR) vaccine you are most likely immune to measles.
If your rubella test, which is performed routinely in pregnancy, is positive, then you are most likely immune to measles.
If you are unsure and are traveling to an area with an active outbreak your provider can order a blood test to see if you are immune to measles.
How should I assess measles immunity before pregnancy?
If you are planning a pregnancy and do not have documentation that you received the MMR vaccine, then ask your health care provider to order a blood test to determine if you are immune to rubella and measles.
If the blood test finds you are not immune, then you should receive the MMR vaccine. After receiving the MMR vaccine, women should wait at least 4 weeks before becoming pregnant.
What should I do if I’m pregnant and suspect I’ve been exposed to measles?
If you suspect you have been exposed to measles, you should call your doctor immediately.
If you don’t have symptoms, and are unsure whether you are immune to the virus, you should undergo a blood test to screen for measles immunity. If you are immune, no further treatment is necessary.
If you are not immune, you are susceptible to the measles virus and should receive intravenous immunoglobulin (IVIg) medication within 6 days of exposure. IVIg medication is used to strengthen your immune system to lower the risk of infection.
If you are not immune to measles, you should receive the MMR vaccine immediately after delivery. The MMR vaccine is safe in breastfeeding mothers.
What should I do if I am pregnant and I have symptoms of measles?
If you are pregnant and suspect you have measles, call your health care provider immediately. Your doctor will likely order a test that uses a sterile swab to collect secretions inside of your nose to check for the presence of the measles virus. He or she might also suggest you receive a blood test to determine if you are immune to measles.
If you have measles, you should stay home for at least four days after you develop the rash to avoid spreading the virus to others. You should also wash your hands often with soap and water, disinfect frequently touched surfaces, cover your nose and mouth with a tissue when you cough or sneeze, and avoid sharing drinks and utensils.
How is measles treated in pregnant women?
Treatment of measles in pregnant women involves supportive therapy; there are no antiviral medications available to treat the measles infection.
Because of the increased risk for complications, pregnant women with measles require close monitoring and assessment of their lung function.
If you have a suspected or confirmed measles infection, you should avoid travel and limit close contact with others for 4 days after a rash appears.