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The U.S. has spotted its first case of monkeypox this year in a pregnant woman, Centers for Disease Control and Prevention officials said over the weekend. The baby was delivered safely and both are “doing well.”

Pregnant women are among those the agency warns may be “at especially increased risk for severe outcomes” from monkeypox. 

“There has been a case of a pregnant woman who delivered,” the CDC’s Dr. John Brooks told a webinar hosted by the Infectious Disease Society of America on Saturday.

Brooks said the baby did not appear to have contracted the disease from their mom during the pregnancy, as has been reported during some previous outbreaks abroad. 

CDC officials said the newborn was given an infusion of immune globulin, an antibody treatment which the agency has permission from the Food and Drug Administration to deploy during monkeypox outbreaks. 

“That neonate received the IG prophylactically. And both mom and baby are doing well,” said the CDC’s Dr. Brett Petersen on the webinar. 

A CDC spokesperson did not return a request for comment on where the case in a pregnant mother was identified.

News of the infection comes as the CDC’s tally in the current outbreak has reached 3,487 nationwide across 45 states as well as the District of Columbia and Puerto Rico, as of Monday.

The sum of American monkeypox cases is on pace to eclipse that of Spain’s. The World Health Organization reported on Tuesday that Spain had the most cases of any nation, at 3,596 total.

It also comes just days after health authorities confirmed the first two U.S. cases of monkeypox in children. 

Both of those children – a toddler in California and infant from the U.K. who was traveling through Washington, D.C. – are reported to be faring well, despite being in the age group that has seen the worst mortality in previous monkeypox outbreaks abroad.

As the outbreak has grown, health authorities have warned that the virus risks increasingly infecting these higher risk groups. 

So far, monkeypox cases in the current global outbreak have been reported predominantly among men who have sex with men. Last week, the CDC said it was aware of just eight cases in women.

“I am concerned about sustained transmission because it would suggest that the virus is establishing itself and it could move into high-risk groups including children, the immunocompromised and pregnant women,” the World Health Organization’s Dr. Tedros Adhanom-Ghebreyesus said last month.

The CDC says data on exactly how often monkeypox leads to severe outcomes in pregnant people remains limited. Diagnosing monkeypox during pregnancy can also be challenging, the agency says in its guidance, before the disease’s characteristic rash appears. 

A 2017 study of four pregnant women with monkeypox in the Democratic Republic of the Congo saw two result in miscarriages and one fetal death. Smallpox, monkeypox’s more lethal cousin, had also been linked to potentially higher severity in pregnancy before it was eradicated.

The CDC currently urges that “pregnant, recently pregnant, and breastfeeding people should be prioritized for medical treatment if needed.” 

The antiviral drug tecovirimat, also known as TPOXX, can also be used to treat pregnant patients and appeared not to result in worrying side effects when deployed in animal studies. The Jynneos vaccine, which is being offered for people at risk in the U.S., was also studied in pregnant animals and did not raise any concerns.

However, both the drug and vaccine have not been specifically trialed in people during pregnancy.

“Because human data is lacking, healthcare providers should discuss the risk and benefits with the patient using shared decision making,” the CDC says.

The current outbreak has seen no deaths in the U.S. despite reports of at-times excruciating rashes and lesions that can last for weeks. 

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