Chronic Infection of Domestic Cats with Feline Morbillivirus, United States.

a case in which a baby was not infected by breast milk from his EBOV-positive mother. However, it should be noted that the woman’s breast milk was never tested while she was breast-feeding baby 2. The literature on EBOV in breast milk of EBOV-positive patients is extremely scarce (3). In a previous study from the 2000 Sudan EBOV outbreak in Gulu, Uganda, breast milk from a convalescent-phase patient was sampled 15 days after symptom onset and tested positive for EBOV by RT-PCR and virus culture (4). Another study conducted in Guinea during the current outbreak, reported a mother– baby pair in which EVD developed in the baby 14 days after symptom onset in the mother, but breast milk from the mother sampled 17 days after symptom onset was negative by EBOV RT-PCR (1). It is unclear whether infectious virus or defective particles are being secreted in breast milk. Ct values were consistently lower in breast milk than in blood when tested concomitantly, but in this case, breast milk samples were not collected until day 6. Our findings suggest that breast milk is infected by EBOV at a later stage of the disease than blood but then follows the expected replication kinetics observed in venous blood. Considering the high EVD death rate, until further evidence is found, we recommend that EBOV-positive women stop breast-feeding immediately and that breast-feeding not be resumed until 2 negative RT-PCR tests of the breast milk have been confirmed. This suggestion is in line with the World Health Organization recommendation for testing semen in male EVD survivors (5). The public health risk for EBOV to remain in breast milk for at least 26 days after EVD symptom onset and for breast milk to possibly be infectious after a patient has cleared the virus from the blood should also be acknowledged.