NEWARK, Del. (WPVI) — Measles cases in Pennsylvania now top 1,300, with 31 new ones reported since Monday.

Two more counties have cases, too, bringing the county total to 44.

Pregnant women are becoming a major concern.

More than 60 are among the 1,317 reported cases, but health experts believe the official tally is an undercount because not all cases are being reported.

The Pennsylvania Department of Health has issued an alert giving healthcare providers guidance for caring for pregnant patients.

Dr. Pamela Bailey, an infectious disease specialist at ChristianaCare, says pregnancy lowers immunity, making moms-to-be more vulnerable to complications such as miscarriages, stillbirths, or premature births.

Dr. Bailey says babies face risks, too, both from prematurity and the virus itself.

“Measles, as I mentioned, is very inflammatory and so it can cause a lot of difficulties with respiration or breathing,” she says.

The MMR vaccine can’t be given during pregnancy because it is a live virus, so ChristianaCare doctors are asking women of childbearing age to check their vaccine status, or get vaccinated if they don’t know it.

The MMR vaccine is safe within 28 days of pregnancy, after delivery, and for breastfeeding mothers.

It does not go into breast milk.

Dr. Bailey says she’s happy for the Pennsylvania Department of Health’s alert, since measles has been so rare until recently that most doctors haven’t had much experience with it.

ChristianaCare has had some measles at its Chester County and Maryland facilities.

Chester County has had 92 cases, the third most cases in Pennsylvania after Lancaster County with 457 and Mifflin County with 193 cases.

A CDC infectious disease expert this week joined the 300 state health workers trying to stop the outbreak.

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