Rubeola

Rubeola, more commonly known as the “red measles” or “10-day measles,” is a highly contagious exanthematous viral illness. Although most cases end with full recovery, rare but serious, even fatal sequelae such as encephalitis and pneumonia can occur. The incidence of measles worldwide has decreased dramatically since the introduction of effective vaccines. Nevertheless, outbreaks still occur among clusters of individuals, especially young adults, that vaccination programs have failed to reach. Susceptible young women are at unique risk because measles in pregnancy follows a more complicated course than in nonpregnant adults. Furthermore, pregnancies complicated by rubeola are more likely to end with spontaneous abortion or preterm delivery. In the United States, the currently used rubeola vaccine employs live-attenuated virus and is contraindicated in pregnancy. Nonpregnant women receiving rubeola vaccination should be advised to use effective contraception for 3 months after inoculation. These warnings persist despite the fact that an adverse pregnancy outcome after maternal measles vaccination has not been reported. Obstetrician/gynecologists must be familiar with rubeola and the management of pregnancies complicated by exposure to the disease. Furthermore, practitioners must actively seek and vaccinate susceptible individuals to minimize this ongoing threat to public health.