Study finds high Zika awareness in US pregnant women during outbreak

A study of new mothers in 16 US states and 1 city published yesterday in Emerging Infectious Diseases found that, while over 90% of women pregnant during the 2016 Zika virus outbreak knew about the risks posed by infection, only half discussed it with their doctors.

A mosquito-borne virus, Zika can cause microcephaly (abnormally small head) and other defects in babies born to infected women.

Researchers from the US Centers for Disease Control and Prevention (CDC) used the agency's Pregnancy Risk Assessment Monitoring System, a state-specific, a monitoring program that surveys a random sample of mothers 2 to 6 months after a live birth.

Of the 8,711 women who responded to the survey, most were 25 to 34 years old (59.7%), were non-Hispanic white (56.9%), had more than a high school education (65.1%), were married (61.3%), and had private insurance that paid for the delivery (55.8%).

The vast majority (91.9%) said they were aware of CDC advisories to avoid travel to regions endemic with Zika while pregnant. Of the women who had heard of Zika, 58.8% said they had talked to a clinician about it, with 63.5% reporting that the clinician brought it up.

Only 8.8% of women said they had not heard of the Zika virus while they were pregnant. These women were more likely than those who had heard of the virus to be non-Hispanic black, have no more than a high school education, say that Medicaid paid for the delivery, and be uninsured at delivery.

"These differences suggest the opportunity to promote patient advocacy so that patients of all backgrounds feel comfortable asking about key topics if they are not raised by the provider, especially in the case of public health threats," the authors wrote.
Apr 15 Emerg Infect Dis study

Pennsylvania notes brucellosis illness linked to raw milk

A paper today in Morbidity and Mortality Weekly Reports (MMWR) describes a case of brucellosis linked to raw (unpasteurized) milk produced in Pennsylvania in 2018. The patient, who lived in New York state, bought the milk from a dairy farm in Pennsylvania.

Brucellosis is a serious disease caused by the Brucella bacteria. This case was caused by Brucella abortus RB51, the live-attenuated vaccine strain used to prevent brucellosis in cattle. While brucellosis can cause fever and chronic illness in any person, it can cause miscarriage and stillbirths in pregnant women.

The Pennsylvania Department of Agriculture identified the cows carrying Brucella abortus RB51 during environmental sampling of the dairy. RB51 was detected and isolated in milk samples collected from the dairy's bulk tank and a single cow.

The report also notes that a New Jersey man tested positive for the RB51 strain in 2017 after drinking raw milk, but the milk source of his infection was not pinpointed.

The authors recommend that all milk be pasteurized before consumption, in line with longstanding public health advice. "During 2007–2012, the number of raw milk outbreaks in the United States increased; 66 (81%) of 81 reported outbreaks occurred in states where raw milk sale is legal," they said.
Apr 17 MMWR report