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  • Flu Treatment Urged for Pregnant Women

    Flu Treatment Urged for Pregnant Women
    The Wall Street Journal/health

    May 13, 2009
    By JENNIFER CORBETT DOOREN
    The Centers for Disease Control and Prevention said Tuesday that pregnant women with flu-like symptoms should be treated with antiviral drugs Tamiflu or Relenza to guard against serious complications of H1N1 influenza.

    The recommendation was highlighted in the agency's daily H1N1 update as the number of confirmed H1N1 influenza cases in the U.S. topped 3,000. The CDC said there have been 3,009 H1N1 cases in 44 states and Washington, D.C., with an additional 600 "probable" cases.

    Anne Schuchat, the CDC's interim deputy director for its science and public-health program, said the agency has seen "some serious complications" with the H1N1 influenza virus in pregnant women and is recommending that pregnant women who are suspected of having any type of flu be given an antiviral drug. One of the three deaths in the U.S. from the new H1N1 influenza virus to date was in a pregnant women.

    Drugs like Tamiflu, by Roche Holding AG, and GlaxoSmithKline PLC's Relenza have been shown to reduce the spread of the flu virus in the body and are most effective if given within 12 to 48 hours of the onset of symptoms.

    Flu symptoms include fever with a cough or sore throat, and often body aches. The CDC has said antiviral treatment should be reserved for patients with more severe illnesses, as well as those in high-risk groups for complications such as young children and people with certain underlying health problems like diabetes and heart disease.

    However, Ms. Schuchat said pregnant women could be more vulnerable to the H1N1 virus because the virus has been seen more often in younger people. In a separate statement issued Monday by the World Health Organization, the agency said the H1N1 virus appears to be more contagious and is affecting young people more often than typically seen with seasonal influenza.

    The CDC is also recommending that doctors consider antiviral treatment for young children and babies though antiviral drugs aren't approved for use in children who are younger than one.

    Being pregnant increases the risk of complications such as pneumonia and dehydration from influenza, whether it's seasonal flu or the H1N1 flu.

    Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com


  • #2
    Re: Flu Treatment Urged for Pregnant Women

    Flu drug advised for pregnant women with swine flu
    By MIKE STOBBE ? 2 hours ago

    ATLANTA (AP) ? Pregnant women should take prescription flu medicines if they are diagnosed with the new swine flu, health officials said Tuesday.

    So far, the swine flu has not proven to be much more dangerous than seasonal influenza, and it's not clear whether or not pregnant women catch swine flu more often than other people. But in general, flu poses added risks for pregnant women, said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention.

    Pregnancy weakens a woman's immune system, so that she's more likely to suffer pneumonia when she catches the flu. In earlier flu pandemics, infection also raised the risk of a premature birth, said Schuchat.

    Pregnant women with asthma and some other health conditions are particularly at risk for complications.

    Risks from the virus are greater than the unknown risks to the fetus from the drugs Tamiflu and Relenza, Schuchat said at a press conference Tuesday.

    "We really want to get the word out about the likely benefits of prompt antiviral treatment" for pregnant women, she said. CDC officials recommend Tamiflu for pregnant women.

    Still, the flu medicines' effectiveness is somewhat limited, studies have shown. They can relieve symptoms and shorten the disease by about a day. They only work if started within 48 hours of first symptoms, and little is known about whether they cut the chances of serious flu complications. Most people recover from the flu with no medical treatment.

    But a 33-year-old pregnant Texas woman who had swine flu died last week, after giving birth through an emergency cesarean section. At least 20 other pregnant women have swine flu, including three who were hospitalized.

    Pregnant women with confirmed or suspected cases of swine flu should take the antiviral medicines for five days, the CDC recommends.

    In total, about 3,000 U.S. cases of swine flu have been confirmed through lab testing so far, most of them ages 18 and under. Officials think the actual number of infections is much higher, and that infections are still occurring.

    CDC officials said the swine flu may seem to be mild now, but they worry the virus will mutate into something more dangerous. One concern is that it will combine with the more deadly but less easily spread bird flu virus that has been circulating in Asia and other parts of the world.

    Another concern is that it will combine with the seasonal H1N1 virus that went around over the winter. That virus was not unusually virulent, but it was resistant to Tamiflu ? the current first-line defense against the new swine flu. If the two virus strains combine, it's possible the swine flu will become resistant to Tamiflu as well, health officials worry.

    On the Net:
    CDC swine flu web site: http://www.cdc.gov/h1n1flu/

    Copyright ? 2009 The Associated Press. All rights reserved.

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    • #3
      Re: Flu Treatment Urged for Pregnant Women

      Swine Flu Drug for Pregnant Women
      The New York Times

      By DONALD G. McNEIL Jr.
      Published: May 12, 2009

      Pregnant women who get swine flu are at such high risk for complications like pneumonia, dehydration and premature labor that they should be treated at once with the antiviral drug Tamiflu — even though it is not normally recommended in pregnancy, the Centers for Disease Control and Prevention said Tuesday.

      And because a positive test for the new H1N1 flu can take days, the agency said, Tamiflu should be given to any pregnant patient with flu symptoms and a history of likely contact with someone else with swine flu.

      “If I’m thinking influenza — the classic symptoms, febrile, aching all over, came on all of a sudden — and this flu is in the community, and I’d otherwise give the patient Tamiflu if she wasn’t pregnant, we’re saying, ‘Don’t delay because she’s pregnant,’ ” said Dr. Denise Jamieson, a C.D.C. medical officer. “At that point, the benefit of giving Tamiflu outweighs the risk.”

      snip

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      • #4
        Re: Flu Treatment Urged for Pregnant Women

        MMWR dispatch today:
        Novel Influenza A (H1N1) Virus Infections in Three Pregnant Women --- United States, April--May 2009

        CDC first identified cases of respiratory infection with a novel influenza A (H1N1) virus in the United States on April 15 and 17, 2009 (1). During seasonal influenza epidemics and previous pandemics, pregnant women have been at increased risk for complications related to influenza infection (2--5). In addition, maternal influenza virus infection and accompanying hyperthermia place fetuses at risk for complications such as birth defects and preterm birth (6). As part of surveillance for infection with the novel influenza A (H1N1) virus, CDC initiated surveillance for pregnant women who were infected with the novel virus. As of May 10, a total of 20 cases of novel influenza A (H1N1) virus infection had been reported among pregnant women in the United States, including 15 confirmed cases and five probable cases.* Among the 13 women from seven states for whom data are available, the median age was 26 years (range: 15--39 years); three women were hospitalized, one of whom died. This report provides preliminary details of three cases of novel influenza A (H1N1) virus infection in pregnant women. Pregnant women with confirmed, probable, or suspected novel influenza A (H1N1) virus infection should receive antiviral treatment for 5 days. Oseltamivir is the preferred treatment for pregnant women, and the drug regimen should be initiated within 48 hours of symptom onset, if possible. Pregnant women who are in close contact with a person with confirmed, probable, or suspected novel influenza A (H1N1) infection should receive a 10-day course of chemoprophylaxis with zanamivir or oseltamivir.

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