Pregnant women at risk for swine flu

I’m not much of a hypochondriac. But the latest cases of swine (H1N1) flu involving pregnant women has me wanting to spend the rest of my pregnancy inside a bubble, free of germs.

The first reported Swine Flu death in Palm Beach County last week was a 25-year-old pregnant woman, whose newborn survived. The state’s health department is awaiting official results on another pregnant woman, 27 years old and 26 weeks pregnant, from Wellington who now lies in a medically induced coma to help fight off the illness.

What gives? Hard to say if the women had any pre-existing health issues prior to contracting the flu. But it’s hard to miss what they certainly have in common.

So what’s a pregnant woman to do?

My 4-year-old son’s pre-school has twice in recent weeks sent home notices about Type A flu, including one confirming that a child at the school was positively diagnosed. State epidemiologists are saying that chances are on the high side that those coming down with the flu likely involve the H1N1 strain. That’s because it’s rare to see so many cases during summertime. And to be clear: Most patients recover.

But my bulging belly has me worried if: 1) I’m more at risk and 2) whether I can do anything to fight it if I do become ill. According to the Centers for Disease Control and Prevention (CDC), pregnant women can develop more serious complications from the illness because of changes in their heart, lungs and immune systems during gestation. The World Health Organization on Monday announced that a Swine Flu vaccine wouldn't be ready for wide distribution until the end of the year.

Here are some steps you should take if you or someone you know is pregnant and worried about contracting swine flu:

Talk to your doctor. I did just last week because my 6-year-old niece was diagnosed with Type A flu, and our families had recently vacationed together. The CDC recommends that pregnant women who come down with flu-like symptoms be treated with antiviral prescription medications, such as Tamiflu or Relenza. Your doctor might disagree, as mine did. Many prefer to try to treat the symptoms with, say, Tylenol for a fever, for example. But you should have the conversation and be armed with information to be able to discuss your options – even if they are hypothetical, as they were in my case.

More than ever, practice good hygiene. That means you shouldn’t feel like you’re overreacting if you go wash your hands after shaking hands with that job candidate in the office. Keep a bottle of hand sanitizer on your desk (am grabbing for mine as I write this). And avoid touching your nose, mouth and eyes. My parents, both in their golden years and caregivers to most of their grandchildren, managed to avoid getting the flu from my niece last week even though they cared for her while she was sick. They asked their doctor about prescriptions for Tamiflu as a precaution but never found the need to use them.

Pay close attention to your body. Most pregnant women are tired and live with daily aches and pains. But if you are having trouble breathing, come down with a fever, get a persistent cough, feel dizzy or find yourself completely drained, make an appointment to see your doctor. If it’s truly pressing, visit an emergency room. Your doctor will decide if testing or treatment is needed. Tests to confirm flu usually involve a nasal swab and are best to do soon after you come down with symptoms because antiviral medications work best within the first 48 hours.

POSTED IN: Anne Vasquez (42), Health (84)

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Comments

Seasonal flu viruses aren’t circulating right now, and the CDC is saying that anyone who has flu symptoms should consider that they have an H1N1 infection.

Pregnant women don’t need to have pre-existing health issues to be at increased risk during H1N1 infections. The pregnancy itself is a complicating condition, and pregnant women are listed among those most at risk of severe disease.

There have been numerous pregnant women who have become infected with the H1N1 virus and had very severe disease. These women ended up in the hospital on ventilators. In most of these cases the mothers died. Sometimes the baby survived – sometimes the baby died as well.

Unfortunately Tylenol and over the counter flu medications don’t provide the same protection that antiviral medications provide.

Antiviral medications can be truly lifesaving for pregnant women who have H1N1 infections. It’s not a matter of shortening the course of the disease but saving the life of the mother.

Posted by: starlight | July 13, 2009 11:54 PM

Hi, swine flu hasn't hit our area yet but I sure it will in the winter when its at its highest. I am 27, 23 weeks pregnant & I have a son who is 20 months. I am so worried about any of us getting it. Are you still at high risk if you decide to breast feed?

Posted by: Tina M | July 14, 2009 6:20 AM

LADIES. IF YOU'RE AT A HIGHER RISK FOR THE FLU WHEN YOU GET PREGNANT THAN DON'T GET PREGNANT. I KNOW IT FEELS GOOD WITH THE SEX BUT DON'T DO IT. WAIT UNTIL THE FLU LEAVES YOUR AREA AND THEN GO FOR IT.

Posted by: lisa | July 14, 2009 6:57 AM

Hi Tina. Check out the link above for the CDC. The center actually encourages breastfeeding so that antibodies are passed onto the infant. Even if you get ill and are taking a prescription antiviral medication, it says breastfeeding is still safe. Of course, wear a mask or take other precautions to avoid spreading the germs.

Posted by: Anne Vasquez | July 14, 2009 6:57 AM

How does 2 cases qualify as "a rash?"

Posted by: John Pardo | July 14, 2009 10:06 AM

"So what's a pregnant woman to do?"

How about not being a paranoid moron? TWO out of how many pregnant women?

Posted by: Billy | July 14, 2009 10:35 AM

John: Good point on using the word "rash." Made that change. Billy: Name-calling aside, I thought I should address your point: When you're pregnant and two women in the same county, within a span of a few days either die or are forced into a medically induced coma, it's cause for concern. The purpose of the blog post is to help start a conversation that will help pregnant women prepare or at least ask their doctors the right questions.

Posted by: Anne Vasquez | July 14, 2009 11:52 AM

I know of at least seven other pregnant women who have died in the U.S. in the past few months.

There are probably others. The state health departments will often say "the patient had underlying health conditions." Pregnancy is considered to be one of these underlying health conditions. Unfortunately in the vast majority of cases they are not listing the specific conditions that the patient had. So there may be many, many more pregnant women who are just not being identified.

Here are the deaths of pregnant women that I am aware of:

California: l in Los Angles County and 1 in San Francisco County

Florida 1 in Seminole County and 1 in Palm Beach County

New York 1 in Nassau County

Texas 1 in Cameron County

Illinois 1 in Chicago

There were also at least two deaths of pregnant women in Canada.

The first deaths in the Spain, The Dominican Republic and Honduras were pregnant women. Peru and Costa Rica have each had at least one pregnant woman die from H1N1 infections

These deaths have just been gathered from news reports - I suspect there have been many more.

We know - the CDC states - that pregnant women are at increased risk for severe complications of H1N1 infections.

Posted by: starlight | July 14, 2009 3:46 PM

Thank you for your feed back Anne, Lisa swine flu obveriously wasn't in the country when I fell pregnant. And Billy get a life this site is ment to be for people who are concerned.

Posted by: Tina M | July 14, 2009 4:15 PM

Hi, I live in the Uk. I'm 18 weeks preg with twins. Iv'e got flu symptoms & my doc wants me to start taking Relenza. My fear is that we don't no much about it & can it harm my unborn babys. In the uk there not testing people for swine flu anymore, due to an overload at the labs. Anyone with 2 or more symptoms there giving the meds to. So i might just have normal flu symptoms. I'm in a catch 22, because i dont no if the drugs will hurt my twins or if i have swine flu that will hurt them more. thanx for any feedback. S

Posted by: Shelly | July 15, 2009 6:05 AM

To John Pardo - go get a life and stop abusing the rest of us who just want to get on with our pregnancy in a healthy way. Calling people 'morons' is pathetic. I am 27 weeks pregnant, in Australia where it is our flu season and we are suffering here with a huge increase in H1N1 with many pregnant women giving berth prematurely and on life support due to swine flu. So John, until you grow a uterus and a brain, keep your abusive comments to yourself.

Posted by: Donna B | July 16, 2009 12:41 AM

To John Pardo - go get a life and stop abusing the rest of us who just want to get on with our pregnancy in a healthy way. Calling people 'morons' is pathetic. I am 27 weeks pregnant, in Australia where it is our flu season and we are suffering here with a huge increase in H1N1 with many pregnant women giving berth prematurely and on life support due to swine flu. I also work in a hospital and see what's going on with this virus. So John, until you grow a uterus and a brain, keep your abusive comments to yourself.

Posted by: Donna B | July 16, 2009 12:43 AM

Actually, Donna, the moron was Billy, not John(see above). Anne, I thought your article was well written, informative, and factual. Your advice to discuss individual cases/concerns/symptoms with your physician and not panic is excellent advice. I was just reading an article on another site about concerns with Tamiflu resistance when used too indiscriminantly or for preventative treatment. We all must stay vigilent and well-educated on this opportunistic flu and practice good hand/respiratory hygiene...this strain will be with us for awhile. Again, great article.

Posted by: Julie | July 16, 2009 9:40 PM

Hi guys I’m 28weeks pregnant and I live in New Zealand which is south of Australia and I empathise with Donna.

We are currently right in the midst of flu season.

However I agree with Julie regarding the advice to not panic and stay vigilant, use good hygiene, as well as staying well-educated.

I browse the internet daily for information, and I would suggest visiting several different sites from different countries as this seems the best way to get an overall picture of what’s happening, what’s working, and what’s not.

I’m also keeping a close eye on the developments in Australia as they are the largest southern country currently facing winter with the new virus. And are taking the brunt of the new wave of this particular flu.

They recommended pregnant women wear protective masks, avoid public gatherings, and remain at home if possible.

The WHO are suggesting pregnant women are a priority for any vaccines that may become available.

In response to Shelly, I understand your "catch 22" and you're right, there isn't enough evidence to suggest that the prescribed antivirals are safe during pregnancy. At the end of the day you may need to weigh the lesser of two evils, as there is a lot of information supporting the use of these measures at this time, to ensure both the health and safety of mum and bubs x2.

As you are also only just into your second trimester, premature labour at this stage would be devastating.

At the end of the day you need to make a decision based on the information that you have available, and be confident that you are doing the best under the circumstances.

I wish all three of you the very best.

Posted by: Felina | July 21, 2009 2:05 AM

is there a supportive chat board where pregnant women with the swine flu concern talk to each other? reading all your posts, i thought and felt that i was the only pregnant "paranoid" is how i feel, its good to know i'm not alone, i have 3 kids that go back to school soon, that makes me very nervous!

Posted by: veronica sukkary | July 29, 2009 9:06 PM

I went to Kaiser today.
I was told that I most likely had swine flu and not to go back to work for a week. They would not give Tamiflu. They would
not test.

Posted by: betty | July 30, 2009 12:20 AM

I just read that the H1N1 vaccine has MERCURY in it. CA banned the use of it in vaccines until the outbreak of swineflu. I'm moving from Miami to SF - then final destination LA. I'm 14 weeks and VERY concerned about what to do. I've cancelled all travel..except my final flight moving back to CA next month. I've considered wearing a mask on the plane...not sure. Doctor's are saying to get it....I have a feeling it's not a good idea. I'm going with my gut, but I know people back home in CA who have had the flu. I suppose I'll be living indoors full time. Arugh.

Posted by: Stacy | October 23, 2009 2:47 PM