measles Archives - MotherToBaby https://mothertobaby.org/baby-blog/tag/measles/ Medications and More during pregnancy and breastfeeding Mon, 06 Jun 2022 21:54:13 +0000 en-US hourly 1 https://wordpress.org/?v=6.4.3 https://mothertobaby.org/wp-content/uploads/2020/10/cropped-MTB-Logo-green-fixed-favicon-32x32.png measles Archives - MotherToBaby https://mothertobaby.org/baby-blog/tag/measles/ 32 32 The Return of Measles https://mothertobaby.org/baby-blog/the-return-of-measles/ Mon, 06 May 2019 00:00:00 +0000 https://mothertobaby.org/baby-blog/the-return-of-measles/ 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 […]

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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.

About MotherToBaby 

MotherToBabyis 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.

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Birth Defects Prevention Month Series: Vaccination in Pregnancy-It Doesn’t Have to Be a Painful Decision https://mothertobaby.org/baby-blog/vaccination-in-pregnancy-it-doesnt-have-to-be-a-painful-decision/ Sun, 20 Jan 2019 00:00:00 +0000 https://mothertobaby.org/baby-blog/birth-defects-prevention-month-series-vaccination-in-pregnancy-it-doesnt-have-to-be-a-painful-decision/ By Beth Conover, APRN, CGC MotherToBaby Nebraska, UNMC “I am 20 weeks pregnant…when is it safe to get my flu shot?” The texted question came in to the MotherToBaby texting helpline, and the answer that I texted back was simple – “As soon as possible…it’s safe at any time in pregnancy and really important for […]

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By Beth Conover, APRN, CGC MotherToBaby Nebraska, UNMC

“I am 20 weeks pregnant…when is it safe to get my flu shot?” The texted question came in to the MotherToBaby texting helpline, and the answer that I texted back was simple – “As soon as possible…it’s safe at any time in pregnancy and really important for you and your baby!”

Once we are into influenza (flu) season (November to March), pregnant women are strongly recommended to get immunized (vaccinated), regardless of how far along they are in their pregnancy. Yet many women delay, and in the end only about 50 percent of pregnant women get their flu shot.

The flu can cause severe illness and even death in pregnant and postpartum women. The flu shot contains an inactivated virus that won’t make you or your baby sick. It is the most effective way to prevent the flu or help you have less severe symptoms if you do get the flu. Currently the nasal-spray flu vaccination is NOT recommended for pregnant women because it contains live attenuated (weakened) virus.

As if the benefits to you from the flu shot aren’t enough, here’s another one: getting vaccinated while you are pregnant can protect your baby from getting the flu after birth! This is because the antibodies that you develop when you get the flu shot get passed to your developing baby during pregnancy and help protect your newborn for the first few months of life.

Here’s another common question that I get about vaccines during pregnancy.

“I received my diphtheria/pertussis/tetanus (Tdap) shot last year. Since I am already immune, why do I have to get it again in my third trimester of pregnancy?”

The third trimester Tdap booster is to help your baby, not you. Diseases like pertussis (whooping cough) can cause serious life-threatening illness in newborns. When a pregnant woman gets a Tdap booster in her third trimester, she mounts a strong antibody response which is passed on to her baby and helps protect the newborn until the baby starts a vaccination series at 2 months of age.

Some pregnant women are worried about whether immunizations will harm their baby. The scares about vaccines being associated with problems like autism have been debunked. Most vaccines are safe for pregnant and breastfeeding women. A few, such as the measles, mumps and rubella (MMR) and chicken pox vaccinations, contain live attenuated virus and are best given when you are not pregnant. The benefits of protection against disease strongly outweigh any potential risk. That’s why Birth Defects Prevention Month’s Tip ❸ is a really important one: Become up-to-date with all vaccines, including the flu shot. Better yet…if you are thinking about getting pregnant, it’s an excellent time to speak with your health care provider to make sure you are current on all of your recommended vaccinations. Remember, a healthy mother is more likely to have a healthy baby!

Are you interested in learning more about vaccinations in pregnancy or while breastfeeding?

Visit the Mother to Baby website and read all of our vaccine-related fact sheets. There is a general fact sheet on all vaccines, and then specific fact sheets on the influenza vaccine and Tdap vaccine (of course!) but also many others like the Measles, Mumps, and Rubella (MMR), HPV, hepatitis A, and chicken pox vaccinations.

Beth Conover, APRN, CGC, is a genetic counselor and pediatric nurse practitioner. She established the Nebraska Teratogen Information Service in 1986, also known as MotherToBaby Nebraska. She was also a founding board member of the Organization of Teratology Information Specialists (OTIS). In her clinical practice, Beth sees patients in General Genetics Clinic, Prenatal Clinic, and the Fetal Alcohol Syndrome Clinic at the University of Nebraska Medical Center. Beth has provided consultation to the FDA and CDC.

About MotherToBaby

MotherToBabyis 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.

 

 

 

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When Measles Strike, It’s Not The Happiest Place On Earth For Pregnant Women https://mothertobaby.org/baby-blog/when-measles-strike-its-not-the-happiest-place-on-earth-for-pregnant-women/ Wed, 04 Feb 2015 00:00:00 +0000 https://mothertobaby.org/baby-blog/when-measles-strike-its-not-the-happiest-place-on-earth-for-pregnant-women/ By Sonia Alvarado, Senior Teratogen Information Specialist, MotherToBaby CA “Martha,” a 27 year-old pregnant woman from Long Beach, anxiously cried out over the telephone, “What if I have measles?! I’ll never live with myself if my baby suffers because I may not have gotten vaccinated?!” “Let’s take a deep breath, Martha, and walk me through […]

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By Sonia Alvarado, Senior Teratogen Information Specialist, MotherToBaby CA
“Martha,” a 27 year-old pregnant woman from Long Beach, anxiously cried out over the telephone, “What if I have measles?! I’ll never live with myself if my baby suffers because I may not have gotten vaccinated?!” “Let’s take a deep breath, Martha, and walk me through the last couple of weeks,” I calmly replied. “When exactly did you visit Disneyland?”

Granted, this is not the typical conversation one would expect from someone in post-vacation mode, especially after her vacation was at the “happiest place on Earth.” However, as a teratogen information specialist with expertise in preventable birth defects, this not-so-happy call through the MotherToBaby free counseling line didn’t surprise me. Measles (rubeola) has been a popular topic in the news lately with students being kept from attending schools and questions about the safety of visiting the popular theme park where the most recent outbreak appears to have begun, Disneyland, California. So, what did this all mean to a pregnant woman and her developing baby?

It’s odd the topic is alive and well, considering the disease was practically eradicated not so long ago. In the early 1960’s, prior to the availability of the MMR (Measles, Mumps, and Rubella) vaccine, in the U.S. alone an average of 500 people died every year from measles, 48,000 people were hospitalized and 4,000 people suffered encephalitis (inflammation of the brain) from the infection, according to the U.S. Centers for Disease Control and Prevention (CDC). The MMR vaccine was introduced in 1964 and due to successful Federal and statewide vaccination campaigns, public education, and social awareness and acceptance of the benefits of vaccination, the numbers of measles infections began to drop – so much so that by 2004 only 37 measles cases were reported. However, since that historic low, reported measles cases have increased.

In December of 2014 an outbreak was sourced to the Disneyland theme park and initially reporters and the public alike seemed surprised that this had occurred. However, California had reported cases of measles earlier in 2014, and there had been larger outbreaks in other states, including 382 cases in Ohio.

If you are a woman of reproductive age, chances are that you have never seen measles in your lifetime. Measles is a respiratory disease caused by a virus; it spreads in droplets after coughing, much like a cold virus. Measles is very contagious: about 90% of exposed susceptible individuals get measles. If a person has measles, they are infectious four days prior to the rash showing up to a period of about four days after the rash has appeared.

Measles symptoms typically start after 10-14 days and include dry cough, runny nose, fever, red eyes, tiny spots on the inside of the cheek and a skin rash of large red spots that appear all over the body. Fever occurs along with the rash and can climb to 104 degrees and 106 degrees Fahrenheit. Pneumonia and encephalitis can occur and pose a serious and life-threatening complication of the disease.

“Well, I was at Disneyland two weeks ago today. So, I guess I would have had symptoms by now if I was exposed to measles? That’s a relief,” said Martha. “If I had been exposed, would it have been as bad as I think it would have been for my baby? Or am I overreacting?” she asked.

Pregnant women who have exposure to measles and have not been vaccinated previously, or had a previous infection, can acquire the disease and develop all of the same symptoms reported for non-pregnant individuals. It is unknown at this time how the presence of other underlying diseases (such as diabetes, autoimmune disease, HIV infection, and others) may contribute to the severity of symptoms in the pregnant woman, or the risk of death for her or her developing baby. To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, studies suggest that measles infection is associated with an increased risk for miscarriage, stillbirth, prematurity and the baby being born with a measles infection. “In other words, Martha, when it comes to the MMR vaccine, you don’t want to be pregnant and not know if you are protected against measles infection,” I told her. “While the MMR vaccine is not recommended to be given during pregnancy because it’s a live virus vaccine, look through your vaccination records to be sure that you have received the appropriate doses of MMR in the past. If not, talk to your doctor about the possibility of getting vaccinated after you give birth. The MMR can be given to breastfeeding women without concerns for the baby, according to the CDC.”

Vaccination with two doses of the MMR provides almost 100% protection. There are individuals who have the MMR vaccine who do not respond as expected; however, the number of people that fall into this group is very small. Studies of outbreaks where there is documentation of vaccination in medical records find that by a large margin, individuals are more likely to become sick with the measles when they are either not previously vaccinated or under-vaccinated (i.e., they missed the second dose).

In the words of some famous singing dolls, it’s a small world after all…and as we’ve seen during this measles outbreak, close contact with others could mean the quick spread of illness. Getting protected against measles, mumps and rubella is easily available through your doctor’s office or local health department. If you are a planning pregnancy at any time in the future and have not had two doses of the MMR, or don’t know if you have had measles in the past, you should talk to your doctor about getting tested for it or receiving the vaccine.

Sonia Alvarado is a bilingual (Spanish/English) Senior Teratogen Information Specialist with MotherToBaby’s California affiliates. MotherToBaby aims to educate women about medications and more during pregnancy and breastfeeding. Along with answering women’s and health professionals’ questions regarding exposures during pregnancy/breastfeeding via MotherToBaby’s toll-free hotline, email and private chat counseling service, Alvarado has provided educational talks regarding pregnancy health in community clinics and high schools over the past decade.

MotherToBaby is a service of the international non-profit Organization of Teratology Information Specialists (OTIS), a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about vaccines, medications or other exposures, call MotherToBaby toll-FREE at 866-626-6847 or visit MotherToBaby.org to browse a library of fact sheets and find your nearest affiliate.

References:
http://www.cdc.gov/measles/about/history.html
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a6.htm
http://pediatrics.about.com/od/measles/a/measles-outbreaks.htm
http://www.immunize.org/askexperts/experts_mmr.asp

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