Evaluation of infants administered prophylactic intravenous immunoglobulin following exposure to measles

Abstract

Introduction: Intravenous immunoglobulin (IVIG) is an alternative for post-exposure prophylaxis if a vaccine is contraindicated and intramuscular immunoglobulin is unavailable. We retrospectively examined the effect of IVIG administration time on measles development in measles-contact infants younger than 6 months of age.

Methodology: Contact tracing of measles cases was performed by the Istanbul Public Health Directorate (IPHD) between August 24, 2012, and June 16, 2013. The mothers of 187 infants younger than 6 months were found to have negative IgG for measles. Under IPHD supervision, IVIG (0.4 g/kg) was administered to these infants within the first 6-10 days following exposure. These infants were monitored for rash and fever by IPHD for up to 28 days after IVIG prophylaxis. The study was conducted retrospectively, infants were divided into two groups, those who received IVIG at 6 days and later. These groups were compared according to the development of measles.

Results: Only 2 out of 187 infants developed measles after IVIG prophylaxis. No significant difference in measles frequency was observed between infants who received IVIG within the first 6 days after exposure and those who received IVIG after 6 days. Nine infants received IVIG in the first 3 days, and none of them developed measles. The risk of developing measles was higher in infants who had experienced contact at home (p = 0.002).

Conclusion: IVIG administration may provide stronger protection in the first 3 days and may be given until 10 days after exposure.

Keywords: Measles; immunoglobulin; infant; post-exposure prophylaxis.