Meta-analysis: Dengue in pregnant women may pose risk to fetus
A meta-analysis published yesterday in The Lancet Infectious Diseases suggests that dengue infection in pregnant women may increase the risk of adverse fetal outcomes such as preterm birth and low birth weight.
The authors, from the United Kingdom and Brazil, say that little is known about the effects of dengue infection in pregnant women on birth outcomes. Dengue virus is spread by Aedes aegypti, the same mosquito that spreads the Zika virus, which, when contracted during pregnancy, appears to increase the risk of microcephaly in newborns.
Hunting for evidence on the effects of dengue infection on miscarriage, stillbirth, preterm birth, and low birth weight, the researchers found eight studies that met their meta-analysis criteria. The studies included 6,071 pregnant women, 292 of whom were exposed to dengue during pregnancy.
The studies revealed some evidence of an increased risk of miscarriage in dengue-infected women, with an odds ratio of 3.51 (95% confidence interval [CI], 1.15-10.77), but another statistical test indicated the increase was not significant (P = .765).
Preterm birth and low birth weight were the most common adverse outcomes in mothers who contracted dengue, the authors found. The odds ratios were 1.71 (95% CI, 1·06–2·76; P = .058) for preterm birth and 1.41 (95% CI, 0.90–2·21, P = .543) for low birth weight.
The team found only one controlled study that examined the risk of stillbirth. In that case, they calculated the crude relative risk to be 6.7 (95% CI, 2.1-21.3) in women with symptomatic dengue compared with women without dengue.
"Evidence suggests that symptomatic dengue during pregnancy might be associated with fetal adverse outcomes," the authors concluded. "If confirmed, it would be important to monitor pregnancies during which dengue is diagnosed and to consider pregnant women in dengue control policies."
In an accompanying commentary, Gabriel Carles, PhD, an author from French Guiana, writes that the researchers' sensitivity analyses show that symptomatic dengue infections are the ones most likely to affect pregnant women and their fetuses.
"My experience in French Guiana supports these conclusions about the risk of miscarriage, preterm birth, low birthweight, and stillbirth essentially being associated with symptomatic forms of dengue infection," Carles states. "Notably, there have been no reports of a link between dengue virus infection during pregnancy and fetal malformations similar to those reported for another flavivirus, the Zika virus."
Mar 3 Lancet Infect Dis study
Mar 3 Lancet Infect Dis commentary introduction
Saudi Arabia reports 2 more MERS cases, 1 death
Saudi Arabia's Ministry of Health (MOH) today confirmed two new MERS infections in Saudi women and the MERS-related death of a Saudi man.
Both new MERS-CoV (Middle East respiratory syndrome coronavirus) infections involve Saudi women hospitalized in critical condition. The first case-patient is a 67-year-old woman from Buraydah, and the second infection involves a 52-year-old woman from Riyadh.
Neither woman is a healthcare worker, and neither had contact with camels. The MOH has listed their infections as primary, meaning they did not contract the disease from another person.
The MOH also reported two MERS recoveries and one death within the last 24 hours. The death involved a 40-year-old Saudi man from Buraydah whose case was reported yesterday. He was not a healthcare worker and had preexisting health conditions.
A 53-year-old foreign man with preexisting medical conditions living in Abha recovered from the disease, as did a 30-year-old foreign man in Riyadh with no preexisting illness, the MOH said. Neither was a healthcare worker
Saudi Arabia's cumulative total of MERS cases has reached 1,312, including 744 recoveries, 557 deaths, and 11 patients still under treatment, the MOH said.
Mar 4 MOH update
FDA injunction forces sprout producer to cease operations
The Food and Drug Administration (FDA) has forced a Virginia-based producer of soybean and mung bean sprouts to stop operating, after 3 years of recalls and violations, according to an FDA press release yesterday.
The consent decree of permanent injunction was issued by the US District Court for the Eastern District of Virginia against Henry's Farm, Inc., in Woodford, Va. The decree prevents Henry's Farm from receiving, processing, packing, and distributing ready-to-eat soybean and mung bean sprouts, at least until the company can show its equipment and facilities are able to prevent contamination of the products.
Henry's Farm has had a three-year history of pathogen-related recalls and facility sanitation violations, said a report in Food Safety News yesterday. Samples collected from the facility have tested positive for Listeria monocytogenes since 2012, and documented unsanitary conditions at the farm include insect and rodent infestations, dirty food processing equipment, and areas of standing water.
Though Listeria was found at Henry's Farm in 2012 and Virginia food safety officials have been testing samples and documenting violations every four months, the FDA did not file a court complaint to close the facility until Feb 12, Food Safety News said.
Multiple recalls of soybean and mung bean sprouts from Henry's Farm over the past three years have occurred because of Listeria contamination and the lack of traceability codes on sprout packaging. Henry's Farm mainly distributed ready-to-eat sprouts to ethnic groceries in Virginia and Maryland. No illnesses have been reported, the FDA said.
The decree requires Henry's Farm to retain an independent laboratory to test samples, retain an independent sanitation expert, and develop ways to eliminate infestations and other unsanitary conditions on the premises before it will be allowed to resume operations.
Mar 3 FDA press release
Mar 3 Food Safety News article