Medical management of vulnerable populations and co-morbid conditions of victims of bioterrorism

Emerging Infections and Pregnancy

“…The first reported case of Lassa fever, caused by infection with an arenavirus, was described in a pregnant patient. In this initial outbreak, 11 patients and staff members who were exposed to the index patient died ( 31 ). The case-fatality rate is higher for pregnant women, particularly in the third trimester, than for nonpregnant women ( 31 , 32 ).…”

“…In this initial outbreak, 11 patients and staff members who were exposed to the index patient died ( 31 ). The case-fatality rate is higher for pregnant women, particularly in the third trimester, than for nonpregnant women ( 31 , 32 ). Women who have Lassa fever late in pregnancy have the highest circulating levels of viremia and therefore tend to be the sickest.…”

“…Investigations of outbreaks in Africa suggest that Ebola infection may be more severe during pregnancy and that mortality rates are higher. Pregnant women infected with Ebola more often have serious complications, such as hemorrhagic and neurologic sequelae, than do nonpregnant patients ( 31 ). Unlike risk for death from Lassa fever, which is highest during the third trimester of pregnancy, risk for death from Ebola is similar during all trimesters ( 33 ).…”

Prophylaxis and Treatment of Pregnant Women for Emerging Infections and Bioterrorism Emergencies

“…No evidence-based guidelines exist for how drug dosing should be altered during pregnancy ( 1 ). Thus, pregnant women are usually given medication doses and schedules identical to those of nonpregnant adults, despite evidence that effective therapeutic levels and toxicity may be altered by pregnancy ( 4 ).…”

“…Information on the effectiveness and safety of some medical countermeasures is limited for the general population, and even less information is available for pregnant women ( 1 ). Physiologic changes during pregnancy may change the safety profile and efficacy of medications and vaccines for pregnant women.…”