2 September 2019

Dear member

New Zealand College of Midwives Advisory for Midwives: Measles Outbreak

As you will be aware parts of New Zealand are currently experiencing a measles outbreak. We understand that midwives and women will have questions and concerns.

What does this mean for Midwives?

Generally speaking, most women of childbearing age in New Zealand have been immunised against measles as a child.

• If a pregnant woman is known to have been exposed to someone who has been diagnosed with measles, please advise her to contact her general practice team (local practice nurse and or / GP).
• Measles during pregnancy can increase the risk of miscarriage, premature labour or low birth weight baby. If a pregnant woman has contracted measles then referral for a consultation with an obstetrician is advised.
• As a health practitioner you may also be at risk of contracting measles due to your work with young families and the potential for exposure. As measles is highly infectious and individuals are contagious prior to the onset of symptoms, non-immune health professionals may inadvertently be a source of infection. We advise that you consider your own immunity status and consider vaccination.

Key messages for Pregnant Women:

• Generally speaking, most women of childbearing age in New Zealand have been immunised as a child against measles. 
• If you’re pregnant and think you have come into contact with someone with measles, and aren’t sure if you’re immune, you should speak to your midwife and see your general practitioner (GP) as soon as possible.
• If you are not currently immune, and contract measles during pregnancy, you may be at increased risk of miscarriage, premature labour, or having a low birthweight. These effects are not common but it is important to be aware of this.
• If you are pregnant and contract measles during pregnancy, you will be provided with additional care to monitor you and your baby’s wellbeing, and to ensure follow up care for your baby after he or she is born. It is very important to avoid contact with others if there are concerns and you think you may be infectious with the measles. Please make contact with healthcare providers by telephone in the first instance.
• The MMR (Measles Mumps Rubella) vaccine is a live weakened vaccine, so it is not advisable to receive this vaccine while pregnant.

Key messages for mothers with newborn babies:

If you are concerned that your baby has been exposed to measles before they have had their MMR vaccine, see your Practice Nurse and / or GP, and speak to your midwife as soon as possible.

General – Signs and symptoms of measles 

• Respiratory style illness (cough, runny nose, headache) or conjunctivitis in both eyes, and
• Temperature over 38.5 degree Celsius and feeling very unwell, and
• A red blotchy rash that starts on day four / five of the illness, usually on the face and moving to the chest and arms.
• Measles is infectious for four to five days before and for four-five days after the symptoms first show.