While children are “relatively spared” from becoming infected with Ebola due to limited contact with Ebola patients compared to adults, children in Guinea, Sierra Leone, and Liberia have to deal with a myriad of other problems that leave them vulnerable to other diseases and poor health, said Barbara Mahon of the Centers for Disease Control and Prevention at IDWeek.
“There are very few data available specific to children from this epidemic,” she said, noting that 14 percent of reported patients are less than 15 years of age, and that children are just as likely as adults to die from Ebola.
With the collapse of the already-stressed healthcare system, however, children are dying from other treatable diseases, such as malaria or pneumonia, because all healthcare efforts are directed towards Ebola care and control. Routine immunization programs have been suspended, and “we’re expecting outbreaks of vaccine preventable diseases, like measles,” Mahon said.
Mothers both suspected and confirmed of being infected with Ebola are being told not to breastfeed their newborns, although there’s been no specific demonstration of transmission through breastmilk, “but there’s no reason to believe this isn’t the case,” Mahon said. These children are at an increased risk of malnutrition and diarrheal illness because their mothers aren’t able to breastfeed, she said, and many people aren’t able to afford alternatives to breast milk.
“Ebola is an even more devastating disease for pregnant women than it is for others,” she said. Vaginal bleeding is common and profuse, and mortality is extremely high with high rates of miscarriage, she said. Outcomes for infants of infected mothers are very negative: in an outbreak in the Democratic Republic of Congo in the mid-1990s, 11 children born to infected mothers all died within 19 days of age.
Many people Mahon has spoken to on the ground are concerned for the orphans more than any other issue, she said. “This Ebola has a much larger problem that we need to look at, and that problem is the children who are losing their parents, their grandparents, their aunties and uncles are left on their own,” said Mahon, quoting Dr. Roseda Marshall. “What can we put in place to help these children?”
Children also have to deal with the social disruptions that come with outbreaks and the economic impacts that result. There has been civil unrest in places like Monrovia, Liberia, where a 15 year old boy was shot and killed during a riot after quarantine was imposed on the city. Decreased economic activity and effects on foreign trade “will result in an increase in poverty, malnutrition, and death,” for affected children, Mahon said.
Children also face educational deprivation as schools have been shut down for the year, Mahon said. Sierra Leone, however, plans to launch an ambitious effort to reach more than 1 million children with lessons delivered via radio.