Delivery of an Ebola Virus-Positive Stillborn Infant in a Rural Community Health Center, Sierra Leone, 2015

Hilary Bower MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Julian E. Grass MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Emily Veltus MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Aaron Brault MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Shelley Campbell MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Alison Jane Basile MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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David Wang MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Christopher D. Paddock MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Bobbie R. Erickson MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Johanna S. Salzer MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Jessica Belser MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Eunice Chege MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Dean Seneca MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Gbessay Saffa MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Ute Stroeher MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Tom Decroo MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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Grazia M. Caleo MSF Ebola Management Centre Project, Médecins Sans Frontières Operational Centre Amsterdam, Bo, Sierra Leone; Centers for Disease Control and Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Fort Collins, Colorado; World Health Organization, Bo, Sierra Leone; District Health Management Team Surveillance Unit, Sierra Leone Ministry of Health and Sanitation, Bo, Sierra Leone; Luxembourg Operational Research Unit, Médecins Sans Frontières Operational Centre Brussels, Brussels, Belgium; Manson's Unit, Médecins Sans Frontières Operational Centre Amsterdam, London, United Kingdom

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DOI:
https://doi.org/10.4269/ajtmh.15-0619
Volume/Issue:
Volume 94: Issue 2
Page(s):
417–419
Restricted access
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We report the case of an Ebola virus (EBOV) RNA–negative pregnant woman who delivered an EBOV RNA–positive stillborn infant at a community health center in rural Sierra Leone, 1 month after the mother's last possible exposure. The mother was later found to be immunoglobulins M and G positive indicating previous infection. The apparent absence of Ebola symptoms and not recognizing that the woman had previous contact with an Ebola patient led health workers performing the delivery to wear only minimal personal protection, potentially exposing them to a high risk of EBOV infection. This case emphasizes the importance of screening for epidemiological risk factors as well as classic and atypical symptoms of Ebola when caring for pregnant women, even once they have passed the typical time frame for exposure and incubation expected in nonpregnant adults. It also illustrates the need for health-care workers to use appropriate personal protection equipment when caring for pregnant women in an Ebola setting.

Author Notes

* Address correspondence to Hilary Bower, Médecins Sans Frontières Operational Centre Amsterdam, Plantage Middenlaan 14, Amsterdam 1018DD, The Netherlands. E-mail: hilarybower@gmail.com

Authors' addresses: Hilary Bower and Emily Veltus, Médecins Sans Frontières, Operational Centre Amsterdam, MSF Ebola Management Centre Project, Bo, Sierra Leone, E-mails: hilarybower@gmail.com and emilyveltus@gmail.com. Julian E. Grass, Shelley Campbell, David Wang, Christopher D. Paddock, Bobbie R. Erickson, Johanna S. Salzer, Jessica Belser, Dean Seneca, and Ute Stroeher, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: hij3@cdc.gov, iaz6@cdc.gov, iuc9@cdc.gov, cdp9@cdc.gov, bee2@cdc.gov, hio7@cdc.gov, jax6@cdc.gov, zkg8@cdc.gov, and xy8@cdc.gov. Aaron Brault and Alison Jane Basile, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: zlu5@cdc.gov and ajj1@cdc.gov. Eunice Chege, World Health Organization, Bo, Sierra Leone, E-mail: nyambue@yahoo.com. Gbessay Saffa, Sierra Leone Ministry of Health and Sanitation, District Health Management Team Surveillance Unit, Bo, Sierra Leone, E-mail: gbessaysaffa@yahoo.com. Tom Decroo, Médecins Sans Frontières, Operational Centre Brussels, Luxembourg Operational Research Unit, Brussels, Belgium, E-mail: tom.decroo@luxembourg.msf.org. Grazia M. Caleo, Médecins Sans Frontières, Operational Centre Amsterdam, Manson's Unit, London, United Kingdom, E-mail: Grazia.Caleo@london.msf.org.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2016
Received:
24 Aug 2015
|
Accepted:
30 Sep 2015
|
Published Online:
03 Feb 2016
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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