Atypical clinical presentation of Ebola virus disease in pregnancy: Implications for clinical and public health management

International Journal of Infectious Diseases

Andrew Hall¹  Aileen Kitching²  Jan Hajek³  Judith Starkulla⁴  Alie H. Wurie⁵  Katrina Roper⁶  Audrey Rangel⁷  Muhammad Ali Raja⁸  Otim Patrick Ramadan⁹  Rashida Kamara^1,10  Sharmistha Mishra^1,11  Amy Elizabeth Parry^1,12  Vikas Sharma^1,12  Boris I. Pavlin^1,13  Tim O’Dempsey^1,14 

[1]Corresponding author.

[2]International Medical Corps, Lunsar, Port Loko, Sierra Leone

[3]King's College London, Strand, London WC2R 2LS, United Kingdom

[4]Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool L3 5QA, United Kingdom

[5]Ministry of Health and Sanitation, Youyi Building, Freetown, Sierra Leone

[6]Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London SE1 8UG, United Kingdom

[7]St. Michael's Hospital, 30 Bond St, Toronto, ON M5B 1W8, Canada

[8]University of British Columbia, Vancouver, BC V6T 1Z4, Canada

[9]World Health Organization, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India

[10]World Health Organization, 61-64, Street, 306 Corner Preah Norodom Blvd (41), Phnom Penh, Cambodia

[11]World Health Organization, Juba, South Sudan

[12]World Health Organization, PO BOX 529, Freetown, Sierra Leone

[13]World Health Organization, PO BOX 5896, Port Moresby, NCD 111, Papua New Guinea

[14]World Health Organization, Rue Jean Baldassini, 69007 Lyon, France

关键词: Ebola;    Pregnancy;    Sierra Leone;    Outbreak;    Epidemic;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown