Ebola and Pregnancy: What is the risk?

As the Ebola outbreak continues to claim lives even outside of Africa, there are many concerns among susceptible groups. Pregnant women are one of these groups that are considered to be at high risk, as are young children, the elderly and people with weakened immune systems like in HIV infection. These susceptible individuals are not only at risk from Ebola, but just about any infectious disease. However, when a relatively uncommon infection like Ebola breaks out, with no known cure or vaccine, then concern is well founded.

Why are pregnant women at risk?

As the U.S. National Library of Medicine paper once stated, the immune system in pregnancy is a unique complexity. It was based on the finding first published in the American Journal of Reproductive Immunology in June 2010. Firstly, it is misleading to broadly state that pregnant women have a weakened immune system. This may be true in cases where pregnant women are not properly nourished, unusually stressed and experiencing complications. However, the immune system as a whole does not ‘malfunction’ in pregnancy.

Instead the issue lies with the alteration of the immune system during pregnancy. It is not weakened in its entirety but just not functioning as it usually would, which is a result of host of changes in the body including the high levels of certain hormones like progesterone. The combination of these factors does make the way the immune system reacts to infectious agents like viruses and bacteria a bit different from the regular response. Ultimately this can increase the susceptibility to certain pathogens.

Ebola and the Immune System in Pregnancy

Ultimately this means that pregnant women should be cautious when outbreaks occur. Humans do not have a natural defense against Ebola. It is one of the many types of viral hemorrhagic fevers that is known to have among the highest mortality rates among humans. Some strains of the Ebola virus have as much as a 90% mortality rate, meaning that 9 out of 10 people infected with that strain of Ebola will die. Other strains have less than a 25% mortality rate. The current 2014 Ebola outbreak is caused by a strain of the more deadly Ebola virus.

Despite the lack of a cure or vaccine coupled with the high mortality rate of this strain, the immune system is not totally incapable to defend the body. This natural defense mechanism is obviously slightly ‘skewed’ in pregnancy. Just how this translates for the current Ebola outbreak in pregnant women cannot be conclusively identified. Many pregnant women in Western Africa who have died were at times refused medical care which inadvertently lowered the chances of survival.

With this in mind, it is important for pregnant women to be cautious, not just for Ebola but for all infectious diseases. With the current Ebola scare it is advisable for women to limit travel to high risk areas even if a ban is not in place. Furthermore, the general Ebola prevention guidelines should be followed like proper hygiene, not touching dead bodies (even at a funeral) and taking note of the early warning signs and seeking medical treatment immediately.

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