Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States

Kamali, Amanda; Jamieson, Denise J.; Kpaduwa, Julius; Schrier, Sarah B.; Kim, Moon J.; Green, Nicole M.; Ströher, Ute; Muehlenbachs, Atis; Bell, Michael; Rollin, Pierre E.; Mascola, Laurene

doi:10.3201/eid2207.160269

Cited by 15 publications

(23 citation statements)

References 31 publications

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“…After her recovery, she developed some weariness, lethargy, loss of appetite, continued joint pain, and spot baldness. She did not report any sleep disturbances, headaches, or vision problems [4]. The woman's symptoms resolved 2-3 months later, and she fully recovered.…”

Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 90%

“…On July 29, the woman began having generalized feelings of malaise, joint and muscle pain. She self-administered antimalarial medications which were effective in treating arthralgia and myalgia [4]. On August 1, the woman developed a fever, and on August 3, she started vomiting and had diarrhea.…”

Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 99%

“…According to the woman, she spent 13 days in an Ebola treatment center, where she was treated with oral rehydration therapy (fluid with modest amounts of sugar and salts used to correct dehydration), and acetaminophen (an antipyretic and pain reliever). In addition, a second course of antimalarial medications was also administered [4]. She was discharged from the Ebola treatment center on August 16, after testing negative for 2 separate EVD real-time reverse transcription PCR results.…”

Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 99%

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Outcomes in Baby Deliveries among Pregnant Ebola Survivors

Chiu¹,

Wu²,

Toy³

et al. 2018

Advances in Ebola Control

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Greater El Monte Community Hospital (GEMCH), the Los Angeles Department of Public Health, and the Centers for Medicare and Medicaid Services assisted in the first documented case of Ebola survivor delivery in the United States. A descriptive qualitative review of GEMCH's events and the limited documented cases of outcomes of baby deliveries among EVD survivors is discussed. Limited resources and capacity in many developing countries impact adversely on the outcomes of the EVD survivors and their neonates. Three lessons for public health workers emerge: (1) the need for the United States to strengthen their capability to manage EVD cases and other highly contagious and severe infectious diseases; (2) the revealing that EVD survivors can deliver normal, EVD free babies when using the recommended guidelines; (3) The need for health care workers to adopt and share the practical procedures in the Recommended Guidelines by the CDC and LADPH from this event are useful and can be shared with the medical fraternity. This case illustrates that EVD survivors can be equally accepted and treated with success at designated health facilities. Demystifying Ebola and eliminating social stigma surrounding the disease is crucial in this undertaking.

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Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 90%

Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 99%

Section: First Documented Evd Survivor Giving Birth In United Statesmentioning

confidence: 99%

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Outcomes in Baby Deliveries among Pregnant Ebola Survivors

Chiu¹,

Wu²,

Toy³

et al. 2018

Advances in Ebola Control

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“…The US Centers for Disease Control and Prevention (CDC) (25) advises against breastfeeding if the mother is infected with human immunodeficiency virus (HIV) (26), while the WHO recommends HIV-infected mothers who are fully supported for antiretroviral therapy should breastfeed (27). The US CDC also recommends that mothers infected with human type I or type II T-cell lymphovirus, or Ebola virus (28) should not breastfeed or express breast milk. These viruses have been confirmed to be transmitted via breast milk, and once infected, they can induce long-term detrimental effects on children's growth and development, and even increase infant mortality.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

Yang

Che

Zhang

et al. 2020

Preprint

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Background: Existing recommendations on whether mothers with COVID-19 should continue breastfeeding are still conflicting. We aimed to conduct a rapid review of mother-to-child transmission of COVID-19 during breastfeeding. Methods:We systematically searched Medline, Embase, Web of Science, Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang, and preprint articles up to March 2020. We included studies relevant to transmission through milk and respiratory droplets during breastfeeding of mothers with COVID-19, SARS, MERS and influenza. Two reviewers independently screened studies for eligibility, extracted data, assessed risk of bias and used GRADE to assess certainty of evidence.Results: A total of 4481 records were identified in our literature search. Six studies (five case reports and one case series) involving 58 mothers (16 mothers with COVID-19, 42 mothers with influenza) and their infants proved eligible. Five case reports showed that the viral nucleic acid tests for all thirteen collected samples of breast milk from mothers with COVID-19 were negative.A case series of 42 influenza infected postpartum mothers taking precautions (hand hygiene and wearing masks) before breastfeeding showed that no neonates were infected with influenza during one-month of follow-up. Conclusions:The current evidence indicates that SARS-CoV-2 viral nucleic acid has not been detected in breast milk. The benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants. Mothers with COVID-19 should take appropriate precautions to reduce the All rights reserved. No reuse allowed without permission.

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“…Furthermore, while no women in the United States had Ebola during pregnancy, CDC Emergency Response Teams (CERT) have been deployed to assist U.S. local hospitals with deliveries of Ebola virus survivors. 7 …”

Section: Descriptionmentioning

confidence: 99%

Addressing Maternal Health During CDC's Ebola Response in the United States

Ellington

Perez

Morof

et al. 2017

Journal of Women's Health

Self Cite

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Previous outbreaks suggest that pregnant women with Ebola virus disease (EVD) are at increased risk for severe disease and death. Healthcare workers who treat pregnant women with EVD are at increased risk of body fluid exposure. Despite the absence of pregnant women with EVD in the United States, CDC activated the Maternal Health Team (MHT), a functional unit dedicated to emergency preparedness and response issues, on October 18, 2014. We describe major activities of the MHT. A high-priority MHT activity was to publish guiding principles early in the response. The MHT also prepared guidance documents, provided guidance and technical support for hospital preparedness, and addressed inquiries. We analyzed maternal health inquiries received through CDC-INFO, MHT, and CDC’s Medical Investigations Team from August 2014 to December 2015. Internal call logs used to capture, monitor, and track inquiries for the three data sources were merged. Inquiries not related to maternal health issues and duplicates were removed. Each inquiry was categorized by route (email/phone), inquirer type, and topic. In total, 201 inquiries were received from clinicians, public health professionals, and the public. The predominant topic was related to infection control for high-risk situations such as labor and delivery. During the Ebola response, most inquiries were received via email rather than telephone, a notable shift compared to the H1N1 emergency response. Lessons learned during the H1N1 and Ebola responses are currently informing CDC’s Zika Response, an unprecedented emergency response primarily focused on reproductive health issues.

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Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States

Abstract: Women who become pregnant after recovery pose little risk for transmitting the virus to the baby or others.

Cited by 15 publications

References 31 publications

Outcomes in Baby Deliveries among Pregnant Ebola Survivors

Outcomes in Baby Deliveries among Pregnant Ebola Survivors

Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

Addressing Maternal Health During CDC's Ebola Response in the United States

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