This BMJ Case Study Shows Just How Dangerous Measles Can Be If You're Pregnant

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You don’t want measles, period. You really don’t want measles when you’re pregnant, when it can cause severe maternal complications and premature birth.

BMJ Case Reports has published a case report of a 27-year-old woman from England, who caught measles when she was seven months pregnant. The woman was admitted to hospital with a fever, sore throat, and elevated heart rate as well as a rash, which had spread from the palms of her hand to her face.

Tests revealed raised inflammatory markers with a lymphopenia, but doctors initially chalked it up to a viral infection – specifically, the flu. The rash, they say in the case notes, lacked the appearance typical of measles and the disease progression suggested a different culprit. And so, measles was low down on the possible diagnosis list.

As already mentioned, measles during pregnancy can cause major complications, and the woman’s state deteriorated a day after admission. She suffered a respiratory infection, which then worsened over the next five days and caused respiratory failure. As a result, the baby had to be delivered prematurely via C-section.

The good news is that both child and mother are fine – the fetus remained unaffected despite the mother’s condition and the woman recovered with treatment. Yet, it was only after her partner came down with the infection that she was tested and a measles diagnosis was finally made.

Measles during pregnancy can be particularly gnarly because it raises the risk of certain complications, including pneumonia and hepatitis. It also increases the risk of death – of 58 pregnant women diagnosed with measles in one 1993 study, 60 percent had to be hospitalized, 26 percent developed pneumonia, and 3 percent died as a result of complications.

It’s not thought that measles creates defects in the fetus, but there are possible links to miscarriage, preterm births, brain inflammation, and neonatal death.

What’s more, measles can be difficult to diagnose in pregnant women because their immune system is repressed, meaning the idiosyncratic morbilliform rash may not be present. As a result, it might take longer to receive the proper treatment.

While stories like this are still relatively rare, medics are concerned about the recent uptick in measles cases. Indeed, there have been a number of outbreaks of measles in the US and Europe (and elsewhere) over the past five years and the numbers of incidents reported only seem to be increasing – the number documented in the US since January 1, for example, has already surpassed last year's total.

The resurgence of a disease that belongs in the 1950s can largely be explained by the high numbers of people, like the woman here, who have not been vaccinated. It comes down to a concept called herd immunity, which requires a certain percentage of any given population to be inoculated against a disease to stop it from spreading. Once this is achieved, a disease can be eradicated.

Contrary to what some people on the internet say, there is no evidence to suggest that vaccinations are unsafe, unless you have an allergy or are immunocompromised (in which case, it can be a good idea to check out the CDC guidelines).

To try and turn the tide on the measles comeback, experts in the UK are now recommending a compulsory vaccination program. Other countries, including France, Italy, and Australia, have or are considering introducing similar policies.

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