15 March 2019
General Information for midwives about the Canterbury Measles Outbreak
As you will be aware Canterbury is currently experiencing a measles outbreak. The College continues to liaise with the Canterbury District Health Board (CDHB), Community and Public Health specialists about the specific measles outbreak in Canterbury. However we understand that midwives and women in other regions may 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. Women who are unsure of their immunisation status can seek advice from their GP.
- 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 immediately who can organise administration of immunoglobulin to provide protection. Immunoglobulin can be given to non immune pregnant women (and is effective) up to 6 days after exposure to a confirmed case – but not during the illness.
- Measles during pregnancy can increase the risk of miscarriage, premature labour or low birth weight baby. Referral for a consultation with an obstetrician is advised.
- Following birth, breastfeeding can provide passive immunity from the immunised mother to her new born baby1.
What happens if an outbreak occurs in another region?
- Response to the outbreak will be via a coordinated health response specific to the region and guidance for health providers will be provided accordingly
- Close liaison with midwifery leaders in your region will be key as they will be linked in with the DHB’s response in your region
Key messages to share with Pregnant Women:
- 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.
- Generally speaking, most women of childbearing age in New Zealand have been immunised as a child against measles. Women who are unsure of their immunisation status can seek advice from their GP.
- If a pregnant woman is not immune, and contracts measles during pregnancy, she may be at increased risk of miscarriage, premature labour, or a low birthweight baby. These effects are not common however it is important to be aware of this.
- If you 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 while you are 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
Breastfeeding can pass immunity to your baby. Breastfeeding is strongly encouraged, especially for babies under 12 months of age, as this can provide protection against measles.
If you are concerned that your baby has been exposed to measles before they have had their MMR vaccine, see your 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.
1 Note: Passive immunity is the passing of antibodies from an immune person to a non-immune person, providing temporary protection against disease-causing bacteria or viruses. Maternal antibodies are transferred to a baby in utero (via the placenta) and through breastfeeding (via colostrum and breastmilk).
For further information see the Communicable Diseases Manual measles chapter: https://www.health.govt.nz/our-work/diseases-and-conditions/communicable-disease-control-manual/measles
and the Immunisation Handbook chapter https://www.health.govt.nz/system/files/documents/publications/immunisation-handbook-2017-2nd-ed-mar18-v4.html#_Toc508280420