Abstract

Pregnant unvaccinated women and their unborn children are at increased risk for complicated measles during outbreaks. Because measles serologies are not routinely performed during pregnancy, mothers-to-be can be unaware of their susceptibility and of the subsequent risk for their offspring. Furthermore, there are no guidelines for the management of congenital measles.

We report a case of congenital measles and its management during the current measles outbreak in Switzerland.

The mother developed severe disease one week before delivery, after being infected by an unvaccinated child. Treatment was supportive and her condition improved over two weeks. Elective caesarian section was performed one week later for medical reasons, when it was established that the mother wouldn’t be contagious to the newborn. Although the child was born without any clinical signs of disease, measles virus was detected in several mucosal samples by RT-PCR. RT-PCR and viral culture were negative in other biological fluids, including CNS. Results suggest the lack of systemic infection (and thus good prognosis) and that the viral transmission occurred probably during delivery (rather than by transplacental infection). The child received several intravenous immunoglobulin injections until all viral detection assays were negative. He had a normal clinical follow-up one year later.

Reports on congenital measles are usually descriptive and don’t integrate molecular techniques such as RT-PCR. Guidelines for the management of congenital measles are necessary. Until then, vaccination strategies should continue to be a priority to prevent congenital and non-congenital measles.