Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management
Background: Between December 2013 and June 2016, West Africa experienced the largest Ebola virus disease (EVD) outbreak in history. Understanding EVD in pregnancy is important for EVD clinical screening and infection prevention and control. Methods: We conducted a review of medical records and EVD i...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220303714 |
| _version_ | 1818149626562215936 |
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| author | Boris I. Pavlin Andrew Hall Jan Hajek Muhammad Ali Raja Vikas Sharma Otim Patrick Ramadan Sharmistha Mishra Audrey Rangel Aileen Kitching Katrina Roper Tim O’Dempsey Judith Starkulla Amy Elizabeth Parry Rashida Kamara Alie H. Wurie |
| author_facet | Boris I. Pavlin Andrew Hall Jan Hajek Muhammad Ali Raja Vikas Sharma Otim Patrick Ramadan Sharmistha Mishra Audrey Rangel Aileen Kitching Katrina Roper Tim O’Dempsey Judith Starkulla Amy Elizabeth Parry Rashida Kamara Alie H. Wurie |
| author_sort | Boris I. Pavlin |
| collection | DOAJ |
| description | Background: Between December 2013 and June 2016, West Africa experienced the largest Ebola virus disease (EVD) outbreak in history. Understanding EVD in pregnancy is important for EVD clinical screening and infection prevention and control. Methods: We conducted a review of medical records and EVD investigation reports from three districts in Sierra Leone. We report the clinical presentations and maternal and fetal outcomes of six pregnant women with atypical EVD, and subsequent transmission events from perinatal care. Results: The six women (ages 18–38) were all in the third trimester. Each presented with signs and symptoms initially attributed to pregnancy. None met EVD case definition; only one was known at presentation to be a contact of an EVD case. Five women died, and all six fetuses/neonates died. These cases resulted in at least 35 additional EVD cases. Conclusions: These cases add to the sparse literature focusing on pregnant women with EVD, highlighting challenges and implications for outbreak control. Infected newborns may also present atypically and may shed virus while apparently asymptomatic. Pregnant women identified a priori as contacts of EVD cases require special attention and planning for obstetrical care. |
| first_indexed | 2024-12-11T13:10:02Z |
| format | Article |
| id | doaj.art-cebc69ae892740d4be2d196aafe2427d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T13:10:02Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-cebc69ae892740d4be2d196aafe2427d2022-12-22T01:06:13ZengElsevierInternational Journal of Infectious Diseases1201-97122020-08-0197167173Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health managementBoris I. Pavlin0Andrew Hall1Jan Hajek2Muhammad Ali Raja3Vikas Sharma4Otim Patrick Ramadan5Sharmistha Mishra6Audrey Rangel7Aileen Kitching8Katrina Roper9Tim O’Dempsey10Judith Starkulla11Amy Elizabeth Parry12Rashida Kamara13Alie H. Wurie14World Health Organization, PO BOX 5896, Port Moresby, NCD 111, Papua New Guinea; Corresponding author.King's College London, Strand, London WC2R 2LS, United KingdomUniversity of British Columbia, Vancouver, BC V6T 1Z4, CanadaWorld Health Organization, PO BOX 529, Freetown, Sierra LeoneWorld Health Organization, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, IndiaWorld Health Organization, Juba, South SudanSt. Michael's Hospital, 30 Bond St, Toronto, ON M5B 1W8, CanadaInternational Medical Corps, Lunsar, Port Loko, Sierra LeonePublic Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London SE1 8UG, United KingdomWorld Health Organization, Rue Jean Baldassini, 69007 Lyon, FranceLiverpool School of Tropical Medicine, Pembroke Pl, Liverpool L3 5QA, United KingdomWorld Health Organization, PO BOX 529, Freetown, Sierra LeoneWorld Health Organization, #61-64, Street, 306 Corner Preah Norodom Blvd (41), Phnom Penh, CambodiaMinistry of Health and Sanitation, Youyi Building, Freetown, Sierra LeoneMinistry of Health and Sanitation, Youyi Building, Freetown, Sierra LeoneBackground: Between December 2013 and June 2016, West Africa experienced the largest Ebola virus disease (EVD) outbreak in history. Understanding EVD in pregnancy is important for EVD clinical screening and infection prevention and control. Methods: We conducted a review of medical records and EVD investigation reports from three districts in Sierra Leone. We report the clinical presentations and maternal and fetal outcomes of six pregnant women with atypical EVD, and subsequent transmission events from perinatal care. Results: The six women (ages 18–38) were all in the third trimester. Each presented with signs and symptoms initially attributed to pregnancy. None met EVD case definition; only one was known at presentation to be a contact of an EVD case. Five women died, and all six fetuses/neonates died. These cases resulted in at least 35 additional EVD cases. Conclusions: These cases add to the sparse literature focusing on pregnant women with EVD, highlighting challenges and implications for outbreak control. Infected newborns may also present atypically and may shed virus while apparently asymptomatic. Pregnant women identified a priori as contacts of EVD cases require special attention and planning for obstetrical care.http://www.sciencedirect.com/science/article/pii/S1201971220303714EbolaPregnancySierra LeoneOutbreakEpidemic |
| spellingShingle | Boris I. Pavlin Andrew Hall Jan Hajek Muhammad Ali Raja Vikas Sharma Otim Patrick Ramadan Sharmistha Mishra Audrey Rangel Aileen Kitching Katrina Roper Tim O’Dempsey Judith Starkulla Amy Elizabeth Parry Rashida Kamara Alie H. Wurie Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management International Journal of Infectious Diseases Ebola Pregnancy Sierra Leone Outbreak Epidemic |
| title | Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management |
| title_full | Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management |
| title_fullStr | Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management |
| title_full_unstemmed | Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management |
| title_short | Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management |
| title_sort | atypical clinical presentation of ebola virus disease in pregnancy implications for clinical and public health management |
| topic | Ebola Pregnancy Sierra Leone Outbreak Epidemic |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220303714 |
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