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In contrast to the risks and prevention of congenital rubella which are well-known in France, the problems that may result from measles, chicken-pox and mumps occurring in the course of pregnancy remain to be delineated. Our experience, based on a long-term prospective study of mothers and full-term infants born after preventive or curative administration of immunoglobulins has led us to the following conclusions. During pregnancy, as far as mumps and chicken-pox are concerned, the risk of fetal involvement seems much lower than is usually believed; however, the numerous documented reports in the medical literature show that this risk is a reality. Measles have become exceptional in adulthood. In the pre and post-partum period, the prevalence and severity of chicken-pox make it an important risk. The correct use of specific immunoglobulins and the strict isolation of affected neonates should reduce the prevalence of neonatal cases. As soon as the risk is known, immediate drastic measures must be taken, in order to achieve the isolation and immunoglobulin protection of babies, mothers and staff members who have been in contact with the infected patient. The study of specific antibodies in young women show that a large proportion of this population is currently receptive to chicken-pox and mumps. A short and long term preventive policy is needed to avoid fetal involvement and severe neonatal infections.

Seven hundred and forty subjects who, between 1980 and 1985, had received intravenous or intramuscular injections of immunoglobulins (Ig) prepared by Cohn fractionation of plasma pools from more than 2000 donors were investigated for anti-HIV antibodies. Anti-HIV antibodies were detected in only one subject, a female drug addict and therefore belonging to a group at high risk of AIDS. In contrast with the huge amounts of Ig received by the remaining 739 subjects (976 litres intravenously, 128 litres intramuscularly), this young woman had only received 10 ml of anti-HBs Ig intramuscularly. The wide scattering in both space and time of these recipients of Ig and the prevalence of anti-HIV antibodies among blood donors in France (0.7 per 1000 in 1985) suggest that all the batches studied (over 100) were contaminated by HIV. The absence in these subjects of seropositive reaction ascribable to the injections of Ig confirms that Cohn fractionation inactivates the virus, as demonstrated in vitro. It is concluded that recipients of Ig prepared from plasma pools not tested for the absence of anti-HIV antibodies should not be regarded as a group at risk of AIDS.