Smallpox: a disease of the past? Consideration for midwives

Monkeypox and the perinatal period: what does maternal-fetal medicine need to know?

BACKGROUND

After the global elimination of smallpox, monkeypox has become the most threatening orthopoxvirus to human health. Very few studies have been reported on pregnant women and newborns. In the case of monkeypox infection, the virus can cause serious adverse pregnancy events in women, which can lead to fetal or neonatal death.

DATA SOURCES

We made a comprehensive review after an extensive literature search in the PubMed/Medline database and websites concerning smallpox and monkeypox.

RESULTS

Two case reports reported a total of nine pregnant women, six of whom had fetal deaths. In the autopsy of a stillbirth, researchers found that the placenta was infected with monkeypox virus, but the mechanism of infection remains unclear. Smallpox vaccine should be administered to acutely exposed pregnant women and newborns. Several novel recombinant vaccinia immunogloblin (rVIG) and human-specific monoclonal antibodies are being developed for the prevention and treatment of monkeypox virus infection. After the fetus was delivered, the newborn should take a bath as soon as possible to remove the amniotic fluid and dirt from the body. The appropriate isolation protocol for the newborn should be selected according to the infection status of the mother. It is not known whether monkeypox virus is present in breast milk, and pasteurized breast milk can be given to newborns when breastfeeding is considered.

CONCLUSION

This review presents an overview of monkeypox in the perinatal period and guides the future research direction.

Monkeypox disease and pregnancy. Where are we today? A review of literature

Monkeypox has emerged as a significant human pathogen, posing severe risks in vulnerable populations. At present, there is not enough data available as to whether pregnant women are more vulnerable to monkeypox infection, or they suffer more severe symptoms, and studies on this issue as well as to the possible adverse effects on the developing fetus are limited. The aim of this review, was to bring together what is known so far about monkeypox virus transmission, the clinical course of the disease, and associated maternal-fetal outcomes. Furthermore, to summarize the current available recommendations on the prevention and management of monkeypox infection during pregnancy, in order to help obstetricians and neonatologists navigate through this new challenging area and provide the best available care to their patients.

Survey of nursing knowledge on bioterrorism

With the aim of identifying intervention programmes within the framework of basic and permanent nursing training, we evaluated the knowledge of 187 nurses and nursing students concerning biological emergencies. A questionnaire was used to identify their knowledge of the pathogens that may be used in a terrorist attack and measures for containing them, and their perception of the danger to public health. Analysis of the responses showed that the undergraduates studying for the Triennial Degree were the best informed, and those studying for the specialist degree were the least informed. The question relating to the precautions adopted against transmission of Bacillus anthracis was the most predictive of the total score because it was the only one with a substantial number of correct answers (79/187). It seems that the information derived more from the generalist media than from academic training. We conclude that there is a need to train qualified personnel capable of responding to a possible emergency in terms of both preventive and interventional medicine.