1. AJPH LETTERS AND RESPONSES
THE FIRST EBOLA SURVIVOR TO
DELIVER A FULL-TERM BABY IN
THE UNITED STATES
In response to the AJPH’s February 2016
issue’s, “International Health Regulations,
Ebola, and Emerging Infectious Diseases in
Latin America and the Caribbean,” we sup-
port the call of importance to West Africa
Ebola Virus Disease’s (EVD) stigma percep-
tion as an international public health con-
cern.1
We report on an Ebola survivor who
successfully delivered a full-term baby at one
of our facilities, Greater El Monte Com-
munity Hospital (GEMCH), in Los Angeles,
California. This incident presented the dif-
ficulties of maintaining long-term follow-ups
including delivery, surgery, and other health
events on EVD survivors as a public health
challenge.
On November 2015, GEMCH treated
a pregnant EVD survivor identified as a
29-year old female physician from Lagos,
Nigeria. She contracted the disease while
treating the first EVD case in Nigeria in July
2014.2
The patient became pregnant in
Nigeria six months after her EVD recovery.
She requested to deliver her baby at GEMCH
by one of the hospital’s obstetrician team she
had been aware of in Nigeria. The mother
successfully gave birth to a nine pound and 1
ounce baby.
GEMCH worked collaboratively with the
Centers for Disease Control and Prevention
(CDC) and the Los Angeles County De-
partment of Public Health (LACDPH)
throughout the patient’s delivery procedure
(Figure 1). Upon delivery, CDC and
LACDPH examined the patient’s blood,
cord-blood, oral and vaginal swabs, breast
milk, first meconium, placenta specimen, and
amniotic fluid. All results returned negative
for EVD. This became the first documented
case in the United States where an EVD
survivor gave birth to a full-term EVD-free
baby.
The health care stigma of EVD has led us to
two critical issues for public health awareness.
First, hospitals in the Southern California
region were unwilling to accept the patient
because of her EVD history. The Centers
for Disease Control and Prevention and the
Los Angeles County Department of Public
Health initially requested to perform the
delivery at a tertiary hospital; however, no
hospital accepted. Second, GEMCH em-
ployees’ fear and reluctance to treat the
patient became an obstacle. Through the
partnership with the Centers for Disease
Control and Prevention and Los Angeles
County Department of Public Health, staff
was educated about transmission and in-
fection control of EVD prior to delivery.
As health care providers, it is our re-
sponsibility to advocate for our patients rather
than to decline treatment because of health
stigma and discrimination.3
This case should
raise awareness that EVD survivors should be
equally accepted and treated at all health
facilities.
Wen-Ta Chiu, MD, DrPH
Stanley Toy Jr, MD
Jonathan Wu, MD, PhD
ABOUT THE AUTHORS
Wen-Ta Chiu is with the College of Public Health, Taipei
Medical University, Taipei, Taiwan. Stanley Toy Jr is with
the Department of Emergency Medicine and Administration,
Greater El Monte Community Hospital, South El Monte,
CA. Jonathan Wu is with the Department of Family
Medicine, Administration, and Quality Control, AHMC
Healthcare Inc., Alhambra, CA.
Correspondence should be sent to Wen-Ta Chiu, CEO and
Chair Professor, AHMC Healthcare Inc., 500 E. Main Street,
Alhambra, CA 91801 (e-mail: wenta.chiu@ahmchealth.com).
Reprints can be ordered at http://www.ajph.org by clicking the
“Reprints” link.
This letter was accepted February 27, 2016.
doi: 10.2105/AJPH.2016.303170
CONTRIBUTORS
All authors contributed equally to this letter.
REFERENCES
1. Espinal M, Aldighieri S, St. John R, Becerra-Posada F,
Etienne C. International health regulations, Ebola, and
emerging infectious diseases in Latin America and the
Caribbean. Am J Public Health. 2016;106(2):279–282.
2. Igonoh A. Your blood tested positive for Ebola. I am
sorry. November 12, 2014. Available at: https://www.
gatesnotes.com/Health/Surviving-Ebola-Dr-Ada-
Igonoh. Accessed March 11, 2016.
3. Faherty LJ, Doubeni CA. Unintended consequences of
screening for Ebola. Am J Public Health. 2015;105(9):
1738–1739.
EDITOR’S NOTE
The authors of “International Health Reg-
ulations, Ebola, and Emerging Infectious
Diseases in Latin American and the Carib-
bean” were invited to provide a response,
and declined the invitation.
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editorajph@qc.cuny.edu.
◢e4 Letters and Responses Chiu et al. AJPH June 2016, Vol 106, No. 6

2. Note. Printed with permission.
FIGURE 1—Letter from Thomas Frieden, Director of the Centers for Disease Control and
Prevention
AJPH LETTERS AND RESPONSES
June 2016, Vol 106, No. 6 AJPH Chiu et al. Letters and Responses e5