Measles immune boost

Babies exposed to measles should be injected with antibodies to temporarily boost their immunity, UK experts say.

The Health Protection Agency researchers also advise lowering the age at which the MMR vaccine can be given in an outbreak to six months.

Measles cases in England and Wales rose by 36% in 2008, largely among children not fully vaccinated with the MMR.

One expert at Great Ormond Street Hospital said measles was particularly dangerous in the very young.

Before the measles vaccine was introduced in 1968, very young babies had some temporary protection from antibodies passed from their mother in the late stages of pregnancy.

But because most mothers now have vaccine-mediated immunity rather than natural immunity against measles, that protection in babies is less than it was, the HPA researchers wrote in Archives of Diseases in Childhood.

By four to five months of age, only 25-45% of babies now have protective levels of measles antibody.

The researchers say because of this and the "worrying" increase in measles cases, babies who have been come in contact with someone with measles should receive an injection of human antibodies to give their immune systems a fighting chance.

This human normal immunoglobulin (HNIG) is made from donor plasma and is currently used in immuno-compromised patients, such as children with leukaemia.

It was also previously offered in outbreaks in infants older than six months but too young for the MMR.

The effects last a few weeks.

Vaccine uptake

Public confidence in the triple MMR vaccine dipped following research - since discredited - which raised the possibility that the jab may be linked to an increased risk of autism.

Experts say MMR uptake needs to hit 95% for herd immunity but in England and Wales uptake of the first of the two vaccine courses is still only 85%.

A total of 1,348 cases of measles were reported last year - the highest figure since the monitoring scheme was introduced in 1995.

Wales is currently seeing a record number of cases and London has been particularly hit by outbreaks.

HPA immunisation expert Dr Mary Ramsay said the use of HNIG was well established.

"As measles is highly infectious, it's spreading easily among school aged unvaccinated children and we have measles outbreaks in schools.

"Cases have also filtered out to the general population.

"We know that in the first year of life, before the age of routine vaccination, measles can cause a severe illness with a high rate of complications."

Dr David Elliman, consultant community paediatrician at Great Ormond Street Hospital, welcomed the proposals.

"There is an argument, that if you are that worried about immunity, what about moving the age of routine immunisation down and people may want to think about that.

"The thing that powers this decision is if you get measles when you're very young it is a more serious disease."

He added that although MMR uptake was now starting to rise once more, measles outbreaks would be seen for quite some time.

"There are still a lot of children who are not immunised and they're now going through school - it is still a significant problem."

Source: BBC News

Guidelines released on average weight gain during pregnancy

The Institute of Medicine (IOM) today issued new guidelines on how much weight to gain during pregnancy. But actually, those guidelines begin before pregnancy.

The IOM wants women of childbearing age at a healthy weight before getting pregnant, for the sake of the health of mother and baby alike. And the IOM wants women to be offered preconception counseling about weight, diet, physical activity -- and contraception, if they're overweight or obese, so that they can lose extra weight before pregnancy.

Then, once a woman gets pregnant, she's supposed to keep her weight gain within certain limits, based on her BMI (body mass index) before pregnancy.

Here are the IOM's weight gain allowances for a woman carrying one child: If she's underweight, she should gain 28-40 pounds. If she's at a normal weight, she should gain 25-35 pounds. If she's overweight, she should gain 15-25 pounds. And if she's obese, she should gain 11-20 pounds.

Does that sound doable to you? Or did you figure that since you're "eating for two," you can double your calories -- especially if you're having cravings or feeling hormonal?

Don't go there, says Melissa Goist, MD, a clinical assistant professor of obstetrics and gynecology at the Ohio State University Medical Center.

A normal-weight woman would need only 300 extra calories per day to maintain a healthy pregnancy with one baby -- that's one-sixth of her prepregnancy calorie budget and roughly the amount of calories in a Snickers bar, Goist says.

Of course, Goist isn't recommending that pregnant women get their extra pregnancy calories from candy bars -- a healthy, balanced diet is the way to go.

Goist says it can be tough to talk to pregnant patients about weight, like her patient who was 8 pounds heavier each month that Goist saw her. Keeping that pace for nine months would put her way over the IOM's recommended weight gain. Plus, Goist says that patient wasn't following her dietary advice -- she was feasting on carbohydrates.

Goist, and the experts who wrote the IOM's new guidelines, say the public hasn't gotten the message that pregnancy isn't a time to ignore weight or eat with abandon.

What do you say? If you've been pregnant, how much weight did you gain, and did your doctor talk to you about it? How hard was it to lose the weight after the baby was born, and would you gain more or less weight if you had to do it all over again?

Source:webMD