Guillet M, Vauloup-Fellous C, Cordier A-G, Grangeot-Keros L, Benoist G, Nedellec S, Benachi A, Freymuth F, Picone O
INSERM U764, laboratoire de microbiologie - immunologie biologique, hôpital Antoine-Béclère, AP-HP, université Paris-Sud, Clamart, France.
J Gynecol Obstet Biol Reprod (Paris). 2012 May;41(3):209-18. doi: 10.1016/j.jgyn.2012.01.008. Epub 2012 Mar 8.
Although measles is usually considered a benign viral disease of childhood, people may be affected whatever their age with severe pneumologic or neurologic consequences are more frequent before 5 years old and after 20 years old. The consequences of a congenital measles, defined as a newborn eruption within 10 days after birth, can be dramatic. The incidence of measles has significantly decreased since first vaccines were introduced in the late 1960s. In France, active immunization for measles is proposed since 1983. Since the beginning of 2008, France has been experiencing a measles outbreak with more than 17,000 notified cases. The current measles outbreak affects more particularly very young children and young adults and, among these, pregnant women. Measles during pregnancy may be severe mainly due to pneumonia. Measles is associated with a risk of miscarriage and prematurity, but congenital anomalies have not been described. If rash occurs near term, the consequences of congenital measles could be severe. Prevention of measles in pregnant women is based on improving immunization coverage, currently insufficient to eradicate virus circulation. The aim of this review is to state on the latest data concerning measles virus, give latest vaccine recommendations, and also to suggest management of measles contact or measles infection during pregnancy.
尽管麻疹通常被认为是一种儿童期的良性病毒性疾病,但无论年龄大小都可能受到影响,严重的肺部或神经系统后果在5岁前和20岁后更为常见。先天性麻疹的后果可能很严重,先天性麻疹定义为出生后10天内出现新生儿皮疹。自20世纪60年代末首次引入疫苗以来,麻疹发病率显著下降。在法国,自1983年起建议进行麻疹主动免疫。自2008年初以来,法国一直经历麻疹疫情,报告病例超过17000例。当前的麻疹疫情尤其影响幼儿和年轻人,其中包括孕妇。孕期麻疹可能很严重,主要是由于肺炎。麻疹与流产和早产风险相关,但尚未发现先天性异常。如果在接近足月时出现皮疹,先天性麻疹的后果可能很严重。预防孕妇麻疹的基础是提高免疫覆盖率,目前这一覆盖率不足以根除病毒传播。本综述的目的是阐述关于麻疹病毒的最新数据,给出最新的疫苗建议,并提出孕期麻疹接触或麻疹感染的管理建议。