Marianne E Zotti, DrPH, MS, FAAN

Marianne E Zotti, DrPH, MS, FAAN

Lead EpidemiologistEmergency Preparedness and Response Program

Applied Sciences Branch/Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health

PromotionCenters for Disease Control and Prevention

Anthrax: Special Considerations forPregnant and Postpartum Women

Public Health Considerations for

Pregnant Women

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

Initially posted at www.cdc.gov on April 28, 2009

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

DRH Program for Emergency Preparedness and Response

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 materialsThis 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 Provider

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.

Local Community

P/PP woman and Family

Local Public Health

Health Care Provider

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 Community

P/PP woman and Family

CDC Partner Organizations State Public Health

Local Public Health

Health Care Provider

CDC Partner OrganizationsState 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 Community

P/PP woman and Family

National Public Health

CDC Partner Organizations State

Public Health

Local Public Health

Health Care Provider

National 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 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.