Dear A-T Families,

Dr. Howard Lederman, Director of the A-T Clinical Center at Johns Hopkins Hospital in Baltimore, Maryland has asked us to pass along his recommendations about measles prevention in people with A-T.


Preventing Measles in People with A-T Who Have Not Been Immunized with the MMR Vaccine

Measles is a highly contagious viral illness that can cause severe health problems including pneumonia, encephalitis (inflammation of the brain) and death in people who develop the infection. There has been a significant increase in the number of measles cases in the United States and around the world due to a drop in immunization rates.

The best way to prevent measles is by immunization with the MMR (measles/mumps/rubella vaccine), but we typically recommend not giving the MMR vaccine to people with A-T because of the risk that the rubella component can cause granulomas (non-healing areas of inflammation) on the skin. Unfortunately, there is no measles vaccine in the U.S. that does not also contain rubella.

We have the following recommendations to keep people with A-T from catching measles:

  • People who have antibody deficiency and are treated with gamma globulin (IgG) get plenty of measles antibody in the gamma globulin preparations, and are not at risk for catching measles.
  • People with normal ability to make antibody who have had 2 doses of the MMR vaccine can be considered immunized and are not at risk for catching measles.
  • People who have not had 2 doses of MMR vaccine and are not getting gamma globulin are at risk for catching measles. Fortunately, there is a 7-10 day incubation period between exposure and developing symptoms, and antibodies to measles can be given after an exposure to prevent infection or make the infection more mild. A significant exposure to someone with measles is being in the same room, home, office, or waiting room with someone who has measles or being there up to 2 hours after the infected person has left. People in this group who have such an exposure should receive a single dose of IV gamma globulin (400 mg IgG/kg) as soon as possible after the contact is identified.
  • We do not generally recommend gamma globulin for people who do not have a direct exposure to measles, but that advice might be modified if there is a very significant local outbreak.
  • Another very important way to prevent measles is for all household members and frequent contacts of A-T patients to get the MMR vaccine unless they have previously had measles. (Most people born prior to 1957 are likely to have been infected naturally and may be presumed to be immune.)

Please reach out to the A-T Clinic Coordinator, Jenny Wright RN, with any questions at 410-614-1922 or jwrigh58@jhmi.edu.

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