Chinese doctors have encountered what could be the first case of mother-to-child transmission of a mysterious viral outbreak, but experts are warning against premature fear.
Doctors at the Wuhan Children Hospital, situated in the epicentre of the outbreak, delivered a baby on Feb. 2 whose mother has the virus, according to state broadcaster CCTV.
Thirty hours after birth, the infant tested positive for the same illness.
Relatively little is known about the novel coronavirus at this point. There is no standard diagnosis, treatment or vaccine. The flu-like bug is contagious — possibly before symptoms even appear — and is able to spread person-to-person, but scientists still aren’t sure exactly how contagious it is.
The case involving a newborn has raised concerns about the ever-changing potential of the epidemic.
At this point, there’s not enough information about the newborn in China know what to make of it, said Dr. Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital.
“Clearly we need to keep an open mind, as we’ve only known about this virus for less than two months and it would not be the first time that we’ve learned something unique about a virus during the course of an epidemic,” he told Global News.
Bogoch pointed to a development made during the height of the Zika virus, when researchers discovered that it could be transmitted sexually, unlike previously thought.
“This was a fascinating development in transmission,” he said. “I’m not saying this coronavirus can be transmitted sexually, but it’s a good example of why we have to be open-minded about the biology of this virus.”
Zika is primarily spread through mosquito bites, but a pregnant woman can pass the virus to her fetus both during pregnancy or around the time of birth, which can cause serious birth defects and other complications.
A number of other viruses have the ability to pass through the placenta and infect a fetus.
Rubella, which is a form of measles, can be passed from mother to child via the placenta during pregnancy or sometimes by breastmilk.
HIV can jump from person to person through blood. Without medicinal intervention, it is possible for an HIV-positive mother to pass the disease during labour, delivery or breastfeeding, according to the U.S. Centers for Disease Control and Prevention.
Mother-to-child transmission is not common behaviour for coronaviruses, but “it’s not impossible,” said Dr. Nisha Thampi, an infectious disease physician at the CHEO, a pediatric health and research centre in Ottawa.
“If it is, in fact, demonstrated that the case in China was an in-utero transmission, it wouldn’t be the first time a virus has done that. We see that with congenital CMV (cytomegalovirus), we see that with HIV and with herpes simplex virus,” she said. “So, while this would be different from other coronaviruses and from what was reported in previous outbreaks, it wouldn’t be all that different.”
The virus currently spreading in China is a specific strain of the coronavirus family that includes everything from the common cold to more deadly diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
There is no conclusive evidence that SARS or MERS is capable of mother-to-child infection, known as “vertical transmission,” but in some SARS cases, expectant mothers who contracted the illness experienced complications during pregnancy or preterm delivery brought on by the virus.
“But these impacts were much more related to the mother’s health status than concerns about the baby,” Thampi said.
A picture posted on Twitter by the China’s People’s Daily newspaper showed the baby in an incubator being treated by a hospital worker in a hazmat suit and goggles.
The doctors said the child was born with stable vital signs and no fever or cough but was experiencing shortness of breath. Chest X-rays showed signs of infection as well as some abnormalities in liver function.
The same hospital reported a second case involving an infant a few weeks earlier. On Jan. 13, a baby was born healthy. Days later, the child’s nanny and mother were diagnosed. By Jan. 29, the child started showing symptoms of the virus. The hospital said that while it’s unclear when the virus was passed to the baby and by whom, the case shows that children aren’t immune.
But there’s still a lot to learn from these cases and the new virus in general, Thampi said.
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Without a full report on what Chinese doctors found in the newborn, it’s hard to know the real risks at play.
“When we see a positive PCR (polymerase chain reaction) test, what we’re seeing is the detection of virus particles, but what we’re not seeing is if it’s an infection in the baby or if the baby picked it up coming through the birth canal and it’s just sitting in the baby, not causing an infection,” she said.
“We’re still learning about modes of transmission for this organism.”
The latest figures on the outbreak show more than 630 deaths, most of which were in central Hubei province, where the strain of coronavirus was first detected. More than 30,000 cases have been confirmed globally as of Feb. 7.
So far, this new coronavirus has infected very few children.
“We’ve had very little in the way in the way of pediatric burden in the novel coronavirus,” Thampi said. “I’m hopeful there will be a more formal report of what they found with this baby, bloodwork, all things to help us to understand. Right now we know very little.”
— with files from Reuters and the Associated Press