Ebola Kills Pregnant Women, Even if They Don't Have It

November 04, 2014 | Pregnancy and Birth, Contraception, Infections ObGyn, ObGyn Nurses
By Amber Tresca

No good deed goes unpunished," Clare Boothe Luce (1903-1987). Eric Duncan, the so-called "patient zero," was the first person residing in the United States to receive a diagnosis of Ebola haemorrhagic fever (EBH). It's thought that he contracted the virus while helping his 7-months-pregnant 19-year-old friend, who ultimately died. Four days later, he flew to the US, already infected, and has since also died of the disease.

The EBH epidemic in West Africa is causing significant human suffering for those who have contracted the disease and their families as well as the health care workers who care for them, many of whom have become victims themselves. The outbreak is also affecting pregnant patients and their maternity care professionals in hard-hit areas—even if they aren't infected.

Because EBH outbreaks in the past have affected relatively small populations of people, there is not much research on how the disease affects pregnant women. One small study of 15 pregnant patients infected with EBH in the Democratic Republic of the Congo in 1999 showed 10 spontaneous abortions and 4 deaths in the third trimester. There was an overall mortality rate of 77% in that particular outbreak but, among these pregnant patients, it was 95.5%.

Pregnancy and the Risks of EBH

In 1976, 11 babies born to mothers during an outbreak also died, and while they did not have typical EBH symptoms, it is suspected that they died of the disease. The exact mode of transmission of EBH from mother to child remains unknown.

The Collateral Damage From Fear and Panic

EBH is clearly a very deadly disease, and not just because it has killed an estimated 55% of those infected. It is also because it has caused panic and the spread of misinformation. Health care workers face an uphill battle as rumors about EBH spread, including that the disease is not real and that it is given through vaccinations, or that it is actually the health care workers that are killing patients. People with symptoms of EBH may be staying away from health care facilities instead of seeking treatment, and some treatment centers and health care workers have come under physical attack. For all these reasons and more, the spread of EBH continues in affected areas, making the infection rates difficult to get under control.

For pregnant patients, EBH also brings the risk of death, even for those who have not been infected themselves or who are not caring for infected family members. It's not thought that pregnancy confers a greater risk of becoming infected. However, in previous outbreaks, women tended to get infected in greater numbers than men, typically as a result of caring for sick relatives. A community ravaged by EBH presents a grim reality for pregnant patients and maternity workers.