New clinical recommendations from the American Academy of Pediatrics help healthcare providers identify, diagnose, and care for infants exposed to measles.


RT’s Three Key Takeaways:

  1. New Clinical Guidance: The American Academy of Pediatrics (AAP) has issued an online clinical guidance tool within its Red Book to assist healthcare providers in diagnosing, managing, and preventing measles in infants born to infected mothers.
  2. Severe Infant Risks: Newborns infected with congenital measles face substantial health risks ranging from rash and multiorgan failure to death, as well as an increased vulnerability to subacute sclerosing panencephalitis (SSPE), a fatal neurodegenerative condition.
  3. Maternal Immunization Impact: Because the measles, mumps, and rubella (MMR) vaccine cannot be administered during pregnancy, clinicians emphasize that immunization before conception is the primary defense to prevent vertical transmission.


The American Academy of Pediatrics (AAP), citing expanding measles outbreaks across the country and a scarcity of clinical resources for clinicians, has developed a guidance tool to assist physicians caring for infants exposed to or infected with the virus.

The guidance, presented as a frequently asked questions document in the online version of the AAP Red Book: 2024–2027 Report of the Committee on Infectious Diseases, addresses the prevention, diagnosis, and management of measles in babies born to individuals infected during pregnancy.

“Our goal is to help pediatricians care for newborns with congenital measles based on the existing evidence,” said Lee Beers, MD, FAAP, chief medical officer of the AAP. “While congenital measles was previously an uncommon condition and therefore the evidence is somewhat limited, this is an urgent need for pediatricians caring for patients in an active outbreak.”

Resurgence in Measles Infections

The guidance comes amid a surge in cases throughout the US. According to data from the Centers for Disease Control and Prevention (CDC), 3,134 confirmed measles cases had been reported nationally as of Sept 3, 2026. The resurgence marks a notable reversal from 2000, when measles was declared eliminated in the US.

In Pennsylvania, two infants died from measles-associated illness, with 577 cases reported in the state as of Sept 4, 2026, the AAP reported. None of those individuals had been fully vaccinated, and outbreaks have emerged in multiple regions of the country, including among unvaccinated pregnant individuals.

“Measles, especially in babies, is not just as simple as getting a rash and it going away,” said Pia Pannaraj, MD, MPH, FAAP, a member of the AAP Committee on Infectious Diseases and a pediatrics professor at the University of California, San Diego, in a news release. “It can have long-term consequences, including severe secondary infections as well as neurological complications down the road.”

Clinical Impact on Newborns

According to AAP estimates, between 25% and 30% of infants delivered to mothers who contract measles in the days immediately preceding delivery may become infected.

Infants with congenital measles can present with outcomes spanning from an absence of symptoms to a classic rash, severe multiorgan failure, or death, according to the AAP. In addition, these infants carry an elevated risk of developing subacute sclerosing panencephalitis (SSPE), an almost universally fatal progressive inflammatory brain disease that typically manifests years after the initial infection.

“It’s important the families are aware so they can watch for any missing milestones,” said Dr Pannaraj, noting that infants may appear asymptomatic at birth before developing signs of disease months or years later, in a news release.

Vaccination and Preventive Recommendations

Because the measles, mumps, and rubella (MMR) vaccine is not recommended during pregnancy, vaccination prior to pregnancy remains the safest and most effective method to prevent infection, according to the AAP.

Under standard guidelines, the AAP recommends that children receive two doses of the MMR vaccine, with the first dose given at 12 months and the second administered between 4 and 6 years of age, with earlier administration recommended under special clinical circumstances.

The organization noted that because data on congenital measles remain limited, the online guidance will undergo ongoing review and updates as new clinical evidence emerges.

“Many providers who have never seen measles except for the textbooks now need to look out for how to identify measles in their patients and what to do to protect them,” said Dr Pannaraj. “This is an issue that isn’t going away.”