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Anthrax: Special Considerations for Pregnant and Postpartum Women Public Health Considerations for Pregnant Women. Marianne E Zotti, DrPH, MS, FAAN. Lead Epidemiologist Emergency Preparedness and Response Program Applied Sciences Branch/Division of Reproductive Health
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Anthrax: Special Considerations forPregnant and Postpartum WomenPublic Health Considerations for Pregnant Women Marianne E Zotti, DrPH, MS, FAAN Lead Epidemiologist Emergency Preparedness and Response Program Applied Sciences Branch/Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention
Outline • Background regarding pregnant women • Division of Reproductive Health (DRH) Response in Recent Pandemic H1N1 Influenza (pH1N1) • DRH Program for Emergency Preparedness and Response • Anthrax project • Model for public health response
Pregnant Women and Catastrophic Events • Classified as ‘at-risk individuals’ • Post-event data often not collected • Disproportionate burden known for some infectious diseases
A Joint Effort: 2008 Pandemic Flu Preparedness Planning • Was the first formal collaboration between DRH & NCBDDD • Convened internal & external experts • Identified pregnancy as a critical area • Identified critical pregnancy, postpartum and infant topics • Antiviral prophylaxis & therapy • Vaccine use • Non-pharmacologic interventions & healthcare planning • Communications to pregnant women & healthcare providers • Intrapartum & newborn issues
DRH Program for Emergency Preparedness and Response • Purpose: Prepare DRH to respond to reproductive health needs of the US population after natural or man-made catastrophic events by: • Gathering epidemiologic/surveillance data to guide action • Developing recommendations and tools to guide public health response specific to pregnant and lactating women and newborns • Developing a plan to reduce fertility risks, infertility, or inadequate contraception • Developing a plan to communicate with clinical, public health and government partners and pregnant women regarding preparedness and response • Developing a human resources preparedness plan for DRH
Anthrax in Pregnant and Postpartum Women • Purpose: discuss issues related to Anthrax in pregnant and postpartum women and newborns • Is a collaborative project with health care providers, professional and public health organizations, federal partners, and within CDC • FY 2011: involved a literature review and a meeting of local experts to discuss how to enhance use of CDC guidance • FY 2012: National expert meeting • FY 2013: Development of guidance documents and communication strategy and materials • This project is supported by funds made available from the Centers for Disease Control and Prevention, Office for Public Health Preparedness and Response, the Division of Reproductive Health, and the Anthrax Management Team.
What’s Different from pH1N1? • Anthrax is usually not transmitted from person to person • US society has little experience with anthrax in humans • Few US medical and public health care providers have experience managing anthrax in humans • No literature about inhalational anthrax among pregnant or postpartum women • Medication and vaccine regimes may be long and complicated • A bioterrorism event brings many unknowns • Public health will have a critical role in distribution of vaccines and medications
Pregnant/postpartum (P/PP) woman and her family Evaluate risk to self, fetus/infant, and family; Identify and use appropriate prevention and treatment modalities P/PP woman and Family
Local Community Support appropriate risk assessment and use of appropriate prevention and treatment modalities. Facilitate public health response efforts in local areas. Local Community P/PP woman and Family
Health Care Providers Provide medical care to P/PP women, and receive training pertaining to anthrax and public health response. Facilitate public health response efforts in local areas. Health Care Provider Local Community P/PP woman and Family
Local Public Health Disperse national guidance and messages for the public using culturally appropriate methods and channels. Facilitate public health response efforts in local areas. Local Public Health Health Care Provider Local Community P/PP woman and Family
CDC Partner OrganizationsState Public Health CDC Partner Organizations State Public Health Disperse national guidance, training, and messages for the public to providers and local partners. Facilitate public health response efforts in local areas. Local Public Health Health Care Provider Local Community P/PP woman and Family
National Public Health National Public Health CDC Partner Organizations State Public Health Develop scientific guidance and messages related to anthrax care and treatment in pregnant and postpartum (P/PP) women. Disseminate guidance and messages through national channels. Local Public Health Health Care Provider Local Community P/PP woman and Family
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.