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CDC Update on coronavirus COVID-19 and pregnancy HERE.

Update as of 2/21/2020

On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, COVID-19. 

  • The CDC has reported 1over 30 COVID-19 coronavirus cases in the U.S. but no deaths.
  • Over 29 countries have reported COVID-19 infections
  • There have been over 75,000 cases and over 2,000 deaths worldwide from the coronavirus COVID-19. Less than 10 of these are outside of China.
  • In perspective: According to the CDC, influenza (the flu) has killed over 34,000 people in the U.S., and an estimated 100,000-200,000 worldwide in the 2018/19 season
  • The mortality rate of the 2002/3 SARS outbreak was reported at 9.6% (774/8,096), and for the 2012 MERS outbreak it was 34.4% (858/2,494), while the mortality rate of COVID-19 is reported to be about 2% as of 2/21/2020. In comparison, the CDC reported the influenza mortality to be about 0.13%.

Pregnancy and Coronavirus COVID-19

UPDATE AS OF 2/12/2020

On 2/12/2020 The Lancet reported on 9 cases of COVID-19 in the third trimester pregnant women. All were delivered by cesarean section. Symptoms of COVID-19 infections in pregnant women were similar to non-pregnant individuals. There was no evidence for intrauterine infection in these 9 cases caused by transmission from the women to the baby. Also, there is no evidence that a cesarean delivery is needed to protect the mother or the fetus.

On 2/3/2020 it was reported that a pregnant woman with Coronavirus infection was delivered by cesarean section in China at 37 weeks. Both mother and baby are doing well.

As of the end of January, most information we have on pregnancy and coronavirus derives from information on MERS and SARS coronaviruses.

One was a report of 5 pregnant women from Saudi Arabia which concluded that MERS-CoV may pose serious health risks to both mothers and infants during pregnancy. Two of the 5 mothers infected with the virus died.

Pregnant women with severe acute respiratory syndrome (SARS) appear to have a worse clinical outcome and a higher mortality rate compared to non-pregnant women. 

Though there were a limited number of pregnant women among these cases, it seems pregnant women are more likely to become infected and those who became infected with SARS were more likely to get sick

Pregnancy is a time of low immune function which generally includes: 

  • older people
  • diabetics
  • people with HIV infection
  • people with long-term use of immunosuppressive agents
  • pregnant women

The flu during pregnancy is a much bigger problem

Pregnant women should be most concerned about getting the flu and getting vaccinated against the flu to protect themselves. As of January 2020, for example, there were over 8,500 deaths from the flu in the US as compared to zero deaths from the Coronavirus. Pregnant women are many times more likely to have severe flu symptoms, to be admitted to the hospital and die than non-pregnant women. That is why every woman should get the flu vaccine.

Coronavirus is not new, but this strain is

You've likely heard the term Coronavirus recently when the new strain, 2019 Novel Coronavirus or COVID-19, was reported in China on January 9. Since then, the fear and confusion surrounding the outbreak, which has resulted in thousands of cases and hundreds of deaths in over 25 countries, has been running rampant. Education is the first step in protecting yourself, during pregnancy and beyond. Here's what you need to know.

Coronaviruses are a group of viruses named for the crown-like spikes (corona=crown) on their surface. Human coronaviruses were first identified in the mid-1960s and there are at least 7 known coronaviruses that can infect people. 

229E and NL63 (alpha coronaviruses), as well as OC43 and HKU1 (beta coronaviruses), are human coronaviruses that people around the world often get infected with, and symptoms are usually mild. However, recently other types of coronaviruses are making people sicker. These usually first infect animals such as bats, cattle, cats, and camels, and then evolve to infect humans:

  • 2019: Novel Coronavirus (COVID-19)
  • 2012: MERS-CoV (beta coronavirus that causes Middle East Respiratory Syndrome,(MERS)
  • 2002: SARS-CoV (beta coronavirus that causes severe acute respiratory syndrome, (SARS)

What is COVID-19 (2019-Novel Coronavirus)?

This is the most recent coronavirus which was reported on January 9, 2020 by the World Health Organization and identified by Chinese authorities. The virus is associated with an outbreak of pneumonia in Wuhan City, Hubei Province, China. As of the end of January 2020, 2019-nCoV has been reported by the CDC  in 19 countries, by far most of them in China.

Two other Coronaviruses have broken out in recent years:

MERS-CoV (Middle East Respiratory Syndrome Coronavirus): MERS-Co was first reported in Saudi Arabia in 2012. It has since caused illness in people from dozens of other countries. All cases to date have been linked to countries in or near the Arabian Peninsula. CDC continues to closely monitor MERS globally and work with partners to better understand the risks of this virus, including the source, how it spreads, and how infections might be prevented.

MERS should not be confused with "MRSA". MRSA is a skin infection and stands for "Methicillin-resistant Staphylococcus aureus". MERS and MRSA are very different diseases, MERS is a virus infection usually starting as pneumonia in the lung, and MRSA is a bacterial infection, usually starting in the skin.

SARS-CoV (Severe acute respiratory syndrome coronavirus): SARS-CoV was first recognized in China in November 2002. It caused a worldwide outbreak in 2002-2003 with 8,098 probable cases including 774 deaths. Since 2004, there have not been any known cases of SARS-CoV infection reported anywhere in the world.

What are the symptoms of COVID-19?

Information on the COVID-19 is evolving nearly daily, and most recent updates can be found on the CDC website. The British Medical Journal (BMJ) has also an informative updated site about coronaviruses. Most of what we know about transmission and symptoms is derived from information on the SARS and MERS coronaviruses. 

Here is what we know about transmission

The virus often affects the respiratory tract leading to lung infection (pneumonia). It can be spread from person-to-person, mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. The spread of SARS and MERS between people has generally occurred between close contacts. While person-to-person transmission usually occurs when someone has symptoms, reports indicate that nCoV transmission can also happen from a person without symptoms.

How easily can the virus be spread?

The majority of patients with COVID-19 present with mild illness, with approximately 20% of cases progressing to severe disease. How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (like measles), while other viruses are less so. It’s important to know this in order to better understand the risk associated with this virus. While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from COVID-19 to the general American public is considered low at this time.

For confirmed COVID-19 infections, reported illnesses have ranged from people being mildly sick to people being severely ill and dying.

Symptoms:

  • fever
  • cough
  • shortness of breath

Less common symptoms include:

  • myalgia
  • fatigue
  • sputum production
  • confusion
  • headache
  • sore throat
  • runny nose
  • chest pain
  • coughing up blood
  • diarrhea
  • nausea/vomiting

The CDC believes as of 1/29/2020 that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 after exposure. This is based on what has been seen previously as the incubation period of MERS viruses. The virus can be transmitted even before a person has any symptoms.

Does wearing a face mask help prevent infection?

You see people in China wearing face masks everywhere all the time, however, it's unclear whether a face mask should be worn by healthy people to prevent infection. But do they work? The answer is not that simple. There isn’t much high-quality scientific evidence on whether masks are an effective safeguard outside health care settings, where experts generally agree that they reduce risks. While wearing a facemask can slow the spread of disease when worn by sick people, the masks do little when worn by healthy people. The masks can prevent large respiratory droplets from other people’s sneezes and coughs from entering your mouth and nose, but gaps around the mouth can still let unfiltered air in. What’s more, people often misuse the masks, or move them aside.

The best way to prevent an infection with coronavirus is to wash your hands regularly with soap and to avoid touching your face.

How to protect yourself from Coronaviruses and the flu

Here is what the CDC recommends:

  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

If you are sick and especially if you have fever, let your doctor know right away.

Read More:
Treating the Cold and Flu During Pregnancy
H1N1 Virus
Infections During Pregnancy