A case of congenital measles

Abstract

Measles is a highly contagious acute viral infectious disease with an airborne and transplacental transmission mechanism caused by an RNA-containing measles virus (genus morbilliviruses, family paramyxoviruses). Vaccination against measles is included in the National Calendar of Preventive Vaccinations of the Russian Federation and is carried out at the age of 12 months, followed by revaccination at 6 years. Immunity after measles is usually lifelong. Post-vaccination immunity is less prolonged: after 10 years, protective antibody titers remain only in 36% of vaccinated. In this regard, in the conditions of an epidemiological outbreak, there is a shift in morbidity to older age groups. Several cases of measles in pregnant women have been described. However, congenital measles is an extremely rare diagnosis. Our article describes a case of congenital measles in a newborn from a 34-year-old woman. At 28 weeks gestation, the woman was diagnosed with pneumonia, then a typical rash appeared. The diagnosis was confirmed by serological method. Thus, the birth occurred in the acute period of the disease. The baby was born prematurely at 28 weeks gestation by Caesarean section. The child's condition at birth was extremely severe. Apgar score is 5/7. The condition of the newborn was extremely severe due to prematurity and multiple pathology. The child was diagnosed with Respiratory distress syndrome of a newborn with respiratory insufficiency of the III degree. On the ninth day of life, a rash appeared. The diagnosis of measles was confirmed by the determination of antibodies to Measilis virus IgM. The course of measles in the exanthemic period was atypical (spotty rash elements on the first day, not characteristic dynamics of rash appearance). However, the presence of perinatal contact, the appearance of rashes made it possible to suspect such a rare diagnosis as congenital measles, and serological diagnostics confirmed this diagnosis. Against the background of the therapy, the patient's condition stabilized on the 7th day of the exanthemic period, the rash regressed. At the age of 1 month and 23 days, the child was discharged home in a satisfactory condition.