Abstract
Although the measles vaccine has been part of routine national childhood vaccination programs throughout Europe, measles remains a public health concern. High numbers of cases and outbreaks have occurred throughout the European continent since 2011, and an increasing number of cases have been reported in Turkey since 2012. During a recent measles outbreak in Turkey, 2 pregnant women contracted measles prior to delivering preterm infants at Hacettepe University Hospital. Measles virus genomic RNA and IgM antibodies against measles were detected in the cord blood of infants and mothers in both cases. The infants were treated with intravenous immunoglobulin (IVIG) and vitamin A. Transient thrombocytopenia was present in 1 infant and treated with an additional dose of IVIG and vitamin A. The infants were discharged, without complications, within 10 days of birth. The successful treatment of these cases suggests that infants who have been exposed to, or infected with, measles may benefit from cotreatment of vitamin A and IVIG.
Highlights
Prior to the introduction of measles vaccination programs, a majority of individuals contracted the measles virus early in childhood and developed lifelong immunity; measles infection during pregnancy was an unusual event
There are some reports regarding the effectiveness of intravenous immunoglobulin (IVIG) treatment to prevent or modify disease, there is no data on the combined treatment of congenital measles with vitamin A and IVIG
We describe 2 preterm infants who contracted measles during this epidemic and their successful treatment with combined IVIG and vitamin A
Summary
Prior to the introduction of measles vaccination programs, a majority of individuals contracted the measles virus early in childhood and developed lifelong immunity; measles infection during pregnancy was an unusual event. The potential risk for measles infection in women of childbearing age has increased [1]. Pregnant woman has a high risk of severe respiratory distress that might cause death [2]. Anselem et al [3] propose that these individuals receive immunoglobulin prophylaxis within 6 days of contact in order to reduce the risk of infection and severe morbidity. Several studies have reported that infected children who receive vitamin A supplements have better outcomes than those who do not [4, 5]. At the time of this publication, 4,172 cases have been reported, constituting an epidemic In this case report, we describe 2 preterm infants who contracted measles during this epidemic and their successful treatment with combined IVIG and vitamin A. Discharge +7 days (b) Figure 1: Clinical follow-up of infants and mothers described in Case 1 (a) and Case 2 (b)
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