Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women

Chambers, Christina D.; Krogstad, Paul; Bertrand, Kerri; Contreras, Deisy; Tobin, Nicole H.; Bode, Lars; Aldrovandi, Grace M.

doi:10.1001/jama.2020.15580

Cited by 227 publications

(270 citation statements)

References 6 publications

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“…explored the efficiency of holder pasteurization against SARS-CoV-2 in 5 milk samples and found that infectivity of all 5 tested SARS-CoV-2 isolates is completely eliminated by this treatment. This confirms studies where holder pasteurization of milk spiked with three early SARS-CoV-2 isolates prevented viral infection of monkey derived Vero cells[7][8][9] . We verify the efficiency of holder pasteurization upon inclusion of additional viral strains, encompassing the dominant pandemic variant D614G that shows increased fitness in cell culture (Netherlands/01, UKEssen) 10 as well as highly susceptible human Caco-2 cells that express the viral entry factor transmembrane serine protease 2 (TMPRSS2).…”

supporting

confidence: 85%

Pasteurization Inactivates SARS-CoV-2–Spiked Breast Milk

et al. 2021

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supporting

confidence: 85%

Pasteurization Inactivates SARS-CoV-2–Spiked Breast Milk

et al. 2021

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“…In one of the cases, SARS-CoV-2 RNA was detected in milk at days 10, 12, and 13, coinciding with SARS-CoV-2 positive diagnostic testing of the newborn, who developed mild COVID-19 symptoms from day 10 on. However, as described by Chambers et al detection of viral RNA by reverse transcriptasepolymerase chain reaction (RT-PCR) does not equate with infectivity (19). Overall, these data highlight the importance of prevention and early detection and follow-up in neonates, in whom management and treatment still need to be defined.…”

Section: Introductionmentioning

confidence: 99%

“…As of August 26, 2020, there had been over 24 million confirmed cases, and more than 800,000 deaths due to the disease (2). The risk of death due to coronavirus disease 2019 (COVID- 19) increases exponentially with age. Thus, mortality rates are in the order of 0.12% in children, but as high as 14.8% in older individuals (3,4).…”

Section: Introductionmentioning

confidence: 99%

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

et al. 2020

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Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical Fernández Colomer et al. Neonatal Infection Due to SARS-CoV-2 manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.

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“…62,63 It is unclear what the impact of freezing and thawing on infectivity would be. However, Walker and colleagues 64 provide evidence that Holder pasteurization (but not cold storage) inactivates SARS-COV2; Unger et al 65 and Chambers et al 66 have also shown that Holder pasteurization inactivates SARS-CoV-2 and the former that holding milk at room temperature for 30 minutes also reduces infectious viral titers.…”

Section: Frameworkmentioning

confidence: 99%

Best Practices for Human Milk Collection for COVID-19 Research

McGuire

Seppo

Goga

et al. 2020

Preprint

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In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs – particularly when it is associated with a novel pathogen – the question will naturally arise as to whether the pathogen can be transmitted via breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens via milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from pre-analytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. Here we provide “best practices” for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.

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Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women

Cited by 227 publications

References 6 publications

Pasteurization Inactivates SARS-CoV-2–Spiked Breast Milk

Pasteurization Inactivates SARS-CoV-2–Spiked Breast Milk

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

Best Practices for Human Milk Collection for COVID-19 Research

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