If a pregnant woman is infected during the first trimester (risk extends to 20th week), a fetus has a 1% chance of developing widespread scarring, hypoplastic limbs, cataracts and brain lesions (congenital varicella). Affected infants have a poor neurodevelopmental outlook.
Risk of neonatal VZV (severe, disseminated disease in newborn) if chickenpox is contracted by the mother 4 days before birth, to 2 days after (risk 20%). Before that, good chance that maternal immune response will protect baby, after that the dose of infection transmitted to the baby via the umbilical cord is likely to be small (although will still be exposed to droplets).
See Maternal for advice on varicella exposure in pregnancy and in neonates.
Biggest Ebola outbreak ever recorded currently in W Africa. Nigeria successfully contained an outbreak imported over the border. Cases in US and Spain, with HCW infected during pre-diagnosis phase.
Enhanced surveillance at Heathrow airport. Some airlines have suspended flights until the end of the year.
No cases yet in UK. But possible. Recognize travel history in patient with history of fever – SIerra Leone, Guinea, Liberia.
No other clinical features, until bruising/bleeding develop!
Spread is from bush meat, esp bats, or else from contact with other cases (alive or dead).
Isolate, use PPE. Use Advisory Committee on Dangerous Pathogens (ACDP) risk assessment guidance document and algorithm.
Inform local Health Protection team.
Other viral haemorrhagic fevers, usually with distinct geographical distribution – Marburg, Crimea-Congo.