title: Delivery of an Ebola Virus-Positive Stillborn Infant in a Rural Community Health Center, Sierra Leone, 2015.
abstract: 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.
authors.affiliation: 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 hilarybower@gmail.com.
authors.forename: Hilary
authors.initials: H
authors.lastname: Bower
authors.affiliation: 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.
authors.forename: Julian E
authors.initials: JE
authors.lastname: Grass
authors.affiliation: 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.
authors.forename: Emily
authors.initials: E
authors.lastname: Veltus
authors.affiliation: 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.
authors.forename: Aaron
authors.initials: A
authors.lastname: Brault
authors.affiliation: 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.
authors.forename: Shelley
authors.initials: S
authors.lastname: Campbell
authors.affiliation: 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.
authors.forename: Alison Jane
authors.initials: AJ
authors.lastname: Basile
authors.affiliation: 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.
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.affiliation: 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.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Paddock
authors.affiliation: 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.
authors.forename: Bobbie R
authors.initials: BR
authors.lastname: Erickson
authors.affiliation: 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.
authors.forename: Johanna S
authors.initials: JS
authors.lastname: Salzer
authors.affiliation: 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.
authors.forename: Jessica
authors.initials: J
authors.lastname: Belser
authors.affiliation: 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.
authors.forename: Eunice
authors.initials: E
authors.lastname: Chege
authors.affiliation: 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.
authors.forename: Dean
authors.initials: D
authors.lastname: Seneca
authors.affiliation: 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.
authors.forename: Gbessay
authors.initials: G
authors.lastname: Saffa
authors.affiliation: 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.
authors.forename: Ute
authors.initials: U
authors.lastname: Stroeher
authors.affiliation: 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.
authors.forename: Tom
authors.initials: T
authors.lastname: Decroo
authors.affiliation: 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.
authors.forename: Grazia M
authors.initials: GM
authors.lastname: Caleo
mesh_terms: D003150:Community Health Workers; D029043:Ebolavirus / Q000302:isolation & purification*; D005260:Female; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology*; D006801:Humans; D008880:Midwifery; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000473:pathology / Q000821:virology*; D012367:RNA, Viral / Q000302:isolation & purification*; D019035:Rural Health Services; D012807:Sierra Leone / Q000453:epidemiology; D050497:Stillbirth; D019562:Viral Load; D055815:Young Adult
chemical_list: D012367:RNA, Viral