Measles Outbreak in Pennsylvania Linked to Rise in Congenital Infections, Including Infant Death

Pennsylvania health officials have issued an alert regarding an increase in measles cases among pregnant women and a corresponding rise in congenital measles, a rare condition not seen in the U.S. for decades. Since April, 66 pregnant women in Pennsylvania have been diagnosed with measles, raising concerns about miscarriage, premature labor, and low birth weight. At least one infant death has been linked to the outbreak; a newborn boy died shortly after birth while his mother was severely ill with measles. The Pennsylvania Department of Health confirmed 1,286 measles cases across 42 counties as of October 19, with 247 hospitalizations and six reported deaths, one of which is still under investigation.

Congenital measles occurs when a mother is infected with measles in the two weeks before birth and the newborn tests positive or develops symptoms within 10 days of delivery. Symptoms can range from rash and fever to pneumonia, neurological problems, and low blood platelets. Doctors have anecdotally reported at least six babies born in Pennsylvania with the condition, with at least two requiring intensive care for pneumonia. The condition can also lead to severe, often fatal, long-term complications like subacute sclerosing panencephalitis (SSPE), which can develop seven to ten years after infection.

The resurgence of congenital measles is attributed to declining vaccination rates, as most women previously had immunity from childhood infections before widespread vaccination. The Pennsylvania Department of Health does not maintain a specific tally of congenital measles cases due to a lack of standardized definitions, but tracks 157 cases in children under 4. The American Academy of Pediatrics recently added a frequently asked questions page about congenital measles to its website in response to increasing outbreaks. The outbreak has been complicated by limited conventional medical access among some affected Amish families, potentially obscuring the true number of cases. Nationally, there have been 4,410 measles cases reported this year.

Where they differ

• ars_technica emphasized that congenital measles cases hadn't been seen in decades before the current outbreak.
• NBC News included a direct quote from a father whose baby died after his wife contracted measles, while Ars Technica did not.
• Ars Technica reported 247 hospitalizations and six deaths (one pending investigation) while NBC News only reported the 66 cases in pregnant women and the anecdotally reported six babies born with congenital measles.

What is not yet known

• The exact number of women who have miscarried or delivered babies with congenital measles remains unknown due to state law and a lack of national tracking.
• The extent to which the outbreak is obscured by limited medical access among Amish families is not fully quantified.

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