Reports from China raised the possibility of so-called vertical transmission of this novel coronavirus -- passing from mothers to infants during pregnancy.
According to Reuters, Chinese doctors reported a case of a patient with coronavirus on Feb. 2 who gave birth to 30 hours later. The report said that the newborn had shortness of breath, chest x-rays showing signs of infection and some liver abnormalities, but no fever or cough.
Viruses, even respiratory illnesses such as the flu, can pass from mother to infant if the mother develops the infection during pregnancy. Speaking from an ob/gyn perspective, Loralei Thornburg, MD, of the University of Rochester Medical Center in New York, told ľֱ that figuring out how a baby got a certain illness can be challenging. It could be transmitted vertically, because the virus has crossed the placenta, or horizontally after birth, for example from a family member (including the mother).
Notably, Thornburg said that while a mother's antibodies can circulate throughout the fetal or neonatal blood, that is not necessarily an indicator of whether or not the baby is infected, only that the baby has the mother's antibodies.
"For a newborn, you actually have to test for the virus itself ... to look for vertical transmission," she said.
Indeed, World Health Organization (WHO) officials said in a press conference on Monday that serological diagnostic testing is a priority for novel coronavirus.
While there is no clinical guidance specifically for ob/gyns on coronavirus, the American College of Obstetricians and Gynecologists' (ACOG) committee opinion on discusses how clinicians should handle any patients who are at "elevated risk" of the flu (such as shortness of breath or pain or pressure in the chest, symptoms that have been clinical features of novel coronavirus).
We "recommend she seek care in an emergency department that treats pregnant women. When possible, send the patient to a setting where she can be isolated," the opinion states.
Prompt treatment with antivirals is recommended for pregnant women with influenza, though obviously that is not yet possible for pregnant women infected with coronavirus.
'Concerning Cases'
While the overall pattern of novel coronavirus cases remains unchanged, WHO director-general Tedros Adhanom Ghebreyesus, MBBS, PhD, cited examples of "concerning instances of onward transmission with no travel history to China" in both France and the U.K. on Monday.
"The detection of these small number of cases could be a spark that becomes a bigger fire, but for now, it's only a spark," he said.
Adding fuel to the fire was a report from Reuters that two of the eight confirmed .
On another front, CNN cited Chinese reports indicating .
Michael Ryan, MD, executive director of WHO's health emergencies program, doubted reports from China that the incubation period could be as long as 24 days, saying that it was more likely that what seems like a long incubation period can reflect "double exposure" to the virus and that "the second exposure is where the infection occurred." He added that this is often seen in Ebola.
Adhanom Ghebreyesus said it is trying to equip labs around the world with the ability to diagnose cases. WHO sent kits to labs in Africa and the Middle East, and 150,000 kits are destined for more than 80 labs in all regions globally, he said.
Ryan said the development of serological assays will help to determine broader population attack rates, "not just who's been infected and who's been sick," he said.
He also downplayed the so-called "super-spreader" event linked to a business conference in Singapore, which has a case cluster of 12 cases. These , including those in the French ski resort, according to reports from Bloomberg.
Ryan recommended a "risk management approach" when asked about the risk of these types of international conferences.
"We're not going to be in a position to say shut down every event. There's no zero risk of anything in life," he noted.