The First Ebola Survivor to Deliver a Full-Term Baby in the United States

In response to the AJPH’s February 2016 issue’s, “International Health Regulations, Ebola, and Emerging Infectious Diseases in Latin America and the Caribbean,” we support the call of importance to West Africa Ebola Virus Disease’s (EVD) stigma perception as an international public health concern.¹ We report on an Ebola survivor who successfully delivered a full-term baby at one of our facilities, Greater El Monte Community Hospital (GEMCH), in Los Angeles, California. This incident presented the difficulties of maintaining long-term follow-ups including delivery, surgery, and other health events on EVD survivors as a public health challenge.

On November 2015, GEMCH treated a pregnant EVD survivor identified as a 29-year old female physician from Lagos, Nigeria. She contracted the disease while treating the first EVD case in Nigeria in July 2014.² The patient became pregnant in Nigeria six months after her EVD recovery. She requested to deliver her baby at GEMCH by one of the hospital’s obstetrician team she had been aware of in Nigeria. The mother successfully gave birth to a nine pound and 1 ounce baby.

GEMCH worked collaboratively with the Centers for Disease Control and Prevention (CDC) and the Los Angeles County Department of Public Health (LACDPH) throughout the patient’s delivery procedure (Figure 1). Upon delivery, CDC and LACDPH examined the patient’s blood, cord-blood, oral and vaginal swabs, breast milk, first meconium, placenta specimen, and amniotic fluid. All results returned negative for EVD. This became the first documented case in the United States where an EVD survivor gave birth to a full-term EVD-free baby.

FIGURE 1—

Letter from Thomas Frieden, Director of the Centers for Disease Control and Prevention

Note. Printed with permission.

The health care stigma of EVD has led us to two critical issues for public health awareness. First, hospitals in the Southern California region were unwilling to accept the patient because of her EVD history. The Centers for Disease Control and Prevention and the Los Angeles County Department of Public Health initially requested to perform the delivery at a tertiary hospital; however, no hospital accepted. Second, GEMCH employees’ fear and reluctance to treat the patient became an obstacle. Through the partnership with the Centers for Disease Control and Prevention and Los Angeles County Department of Public Health, staff was educated about transmission and infection control of EVD prior to delivery.

As health care providers, it is our responsibility to advocate for our patients rather than to decline treatment because of health stigma and discrimination.³ This case should raise awareness that EVD survivors should be equally accepted and treated at all health facilities.