Pregnant In The Time Of Ebola

This comprehensive account of the deadliest Ebola outbreak in history examines its devastating effects on West Africa’s most vulnerable populations: pregnant women and children. Noted experts across disciplines assess health care systems’ responses to the epidemic in Liberia, Guinea, and Sierra Leone, emphasizing key areas such as pregnancy, prenatal services, childbirth, neonatal care, and survivor health among pregnant and non-pregnant women. The 30 chapters hone in on gender-based social issues exacerbated during the outbreak, from violence against women and girls to barriers to female education. At the same time, chapters pinpoint numerous areas for service delivery and policy improvements for more coordinated, effective, and humane actions during future pandemics. A sampling of the topics: Ebola virus disease: perinatal transmission and epidemiology Comprehensive clinical care for children with Ebola virus disease Maternal and reproductive rights: Ebola and the law in Liberia Ebola-related complications for maternal, newborn, and child health service delivery and utilization in Guinea The Ebola epidemic halted female genital cutting in Sierra Leone—temporarily Maternity care for Ebola at Médecins Sans Frontières centers Stigmatization of pregnant women with and without Ebola Exclusion of women and infants from Ebola treatment trials Role of midwives during the Ebola epidemic Pregnant in the Time of Ebola is a powerful resource for public health specialists, anthropologists, social scientists, physicians, epidemiologists, nurses, midwives, and governmental and non-governmental agency staff studying the effects of the epidemic on women and children as a result of the most widespread Ebola outbreak to date.

The Democratic Republic of Congo is currently experiencing the second largest Ebola outbreak in history, following a 2014-2016 outbreak in western Africa that had an estimated 28,000 cases. Investigational treatment and vaccination trials are ongoing, but data in the context of pregnancy and breastfeeding are limited. A paucity of scientific evidence exists on how to best treat pregnant or breastfeeding women with suspected or confirmed Ebola virus disease (EVD). Historical reports suggest that, among women who acquire EVD during pregnancy, there is increased mortality and morbidity, and a near 100% rate of adverse pregnancy outcomes. To save the lives of mothers and their babies, mitigate complications, and limit the spread of disease, it is critical that recommendations are made on the prevention, treatment, and surveillance of women who are exposed to EVD, acquire EVD during pregnancy or breastfeeding, or survive EVD with ongoing pregnancies. These guidelines are the first to provide such recommendations.

Provides effective diagnosis and management of infectious diseases in pregnant women in a single comprehensive available resource for busy clinicians.

The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.

NEW YORK TIMES BESTSELLER • An urgent wake-up call about the future of emerging viruses and a gripping account of the doctors and scientists fighting to protect us, told through the story of the deadly 2013–2014 Ebola epidemic “Crisis in the Red Zone reads like a thriller. That the story it tells is all true makes it all more terrifying.”—Elizabeth Kolbert, Pulitzer Prize–winning author of The Sixth Extinction From the #1 bestselling author of The Hot Zone, now a National Geographic original miniseries . . . This time, Ebola started with a two-year-old child who likely had contact with a wild creature and whose entire family quickly fell ill and died. The ensuing global drama activated health professionals in North America, Europe, and Africa in a desperate race against time to contain the viral wildfire. By the end—as the virus mutated into its deadliest form, and spread farther and faster than ever before—30,000 people would be infected, and the dead would be spread across eight countries on three continents. In this taut and suspenseful medical drama, Richard Preston deeply chronicles the pandemic, in which we saw for the first time the specter of Ebola jumping continents, crossing the Atlantic, and infecting people in America. Rich in characters and conflict—physical, emotional, and ethical—Crisis in the Red Zone is an immersion in one of the great public health calamities of our time. Preston writes of doctors and nurses in the field putting their own lives on the line, of government bureaucrats and NGO administrators moving, often fitfully, to try to contain the outbreak, and of pharmaceutical companies racing to develop drugs to combat the virus. He also explores the charged ethical dilemma over who should and did receive the rare doses of an experimental treatment when they became available at the peak of the disaster. Crisis in the Red Zone makes clear that the outbreak of 2013–2014 is a harbinger of further, more severe outbreaks, and of emerging viruses heretofore unimagined—in any country, on any continent. In our ever more interconnected world, with roads and towns cut deep into the jungles of equatorial Africa, viruses both familiar and undiscovered are being unleashed into more densely populated areas than ever before. The more we discover about the virosphere, the more we realize its deadly potential. Crisis in the Red Zone is an exquisitely timely book, a stark warning of viral outbreaks to come.

This book discusses the emerging challenges of the filovirus infections Ebola and Marburg virus disease. It reviews the complex ecology and role played by bats and other suspected intermediate hosts, including pigs. Also examined are the challenges for other modes of transmission and early diagnosis and detection. The immunology and pathogenesis of the infections and the impact on the host?s immune systems are discussed. The rare occurrence of Marburg virus infection in pregnancy and the long-term consequences of sexual transmission by survivors is further examined. These discussions have the potential to support future management of outbreaks and guide research for vaccines and medication for Ebola and Marburg disease.

Among the many who serve in the United States Armed Forces and who are deployed to distant locations around the world, myriad health threats are encountered. In addition to those associated with the disruption of their home life and potential for combat, they may face distinctive disease threats that are specific to the locations to which they are deployed. U.S. forces have been deployed many times over the years to areas in which malaria is endemic, including in parts of Afghanistan and Iraq. Department of Defense (DoD) policy requires that antimalarial drugs be issued and regimens adhered to for deployments to malaria-endemic areas. Policies directing which should be used as first and as second-line agents have evolved over time based on new data regarding adverse events or precautions for specific underlying health conditions, areas of deployment, and other operational factors At the request of the Veterans Administration, Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis assesses the scientific evidence regarding the potential for long-term health effects resulting from the use of antimalarial drugs that were approved by FDA or used by U.S. service members for malaria prophylaxis, with a focus on mefloquine, tafenoquine, and other antimalarial drugs that have been used by DoD in the past 25 years. This report offers conclusions based on available evidence regarding associations of persistent or latent adverse events.

In the nineteenth century some scientists argued that women should not be educated because thinking would use energy needed by the uterus for reproduction. The proof? Educated women had a lower birth rate. Today's researchers can only shake their heads at such reasoning. Yet professional journals and the popular press are increasingly criticizing medical research for ignoring women's health issues. Women and Health Research examines the facts behind the public's perceptions about women participating as subjects in medical research. With the goal of increasing researchers' awareness of this important topic, the book explores issues related to maintaining justice (in its ethical sense) in clinical studies. Leading experts present general principles for the ethical conduct of research on womenâ€"principles that are especially important in the light of recent changes in federal policy on the inclusion of women in clinical research. Women and Health Research documents the historical shift from a paternalistic approach by researchers toward women and a disproportionate reliance on certain groups for research to one that emphasizes proper access for women as subjects in clinical studies in order to ensure that women receive the benefits of research. The book addresses present-day challenges to equity in four areas: Scientificâ€"Do practical aspects of scientific research work at cross-purposes to gender equity? Focusing on drug trials, the authors identify rationales for excluding people from research based on demographics. Social and Ethicalâ€"The authors offer compelling discussions on subjectivity in science, the evidence for male bias, and issues related to race and ethnicity, as well as the recruitment, retention, and protection of research participants. Legalâ€"Women and Health Research reviews federal research policies that affect the inclusion of women and evaluates the basis for researchers' fears about liability, citing court cases. Riskâ€"The authors focus on risks to reproduction and offspring in clinical drug trials, exploring how risks can be identified for study participants, who should make the assessment of risk and benefit for participation in a clinical study, and how legal implications could be addressed. This landmark study will be of immediate use to the research community, policymakers, women's health advocates, attorneys, and individuals.