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H1N1 Flu Cluster: 5 Bay Area Pregnant Women

Shiloh

Editor, Senior Moderator
Source: http://cbs5.com/local/h1n1.flu.cluster.2.1064748.html

Jun 29, 2009 3:36 pm US/Pacific
H1N1 Flu Cluster: 5 Bay Area Pregnant Women
Reporting
Dr. Kim Mulvihill, M.D.

SAN FRANCISCO (CBS 5) ―

CBS 5 has learned that at least five pregnant women have been hospitalized in Bay Area intensive care units due to complications of the H1N1 swine flu.

Sources said two of the five women are no longer in ICU, but they remained hospitalized. All the fetuses appeared to be fine, the sources indicated.

This may be the first reported cluster of pregnant women infected with H1N1 in the country. One obstetrician who was consulted on all five cases told CBS 5 that he had never seen anything like this before.

All the pregnant women are or were in their early third trimester. Some required intubation or help breathing, sources said.

Some of these women were perfectly healthy, while others had underlying health conditions. While the doctor could not divulge what other health conditions these pregnant women had, the Centers for Disease Control said respiratory conditions such as allergies or asthma or even heart disease, may put a person at a higher risk.

The CDC and the World Health Organization also warned that pregnancy itself may be a risk factor for contracting H1N1.

CDC officials said they don't know why pregnant women may be at a higher risk for contracting swine flu or for complications following a swine flu infection. However, pregnant women, in general, have lowered immune systems.

The doctor interviewed by CBS 5 believes that with infected pregnant women who are in their third trimester, the enlarging fetus in the uterus may be pushing up and against a woman's diaphragm to such a degree, that she can no longer breathe as deeply, and may be at higher risk for pneumonia.

All public health officials and experts agree: if you are pregnant, and experience symptoms, do not panic; do not rush the emergency room or your doctor's office. Instead, call your doctor, describe your symptoms and ask whether you need to be tested.

The symptoms are fever, cough, sore throat, body aches, headaches, chills and fatigue and sometimes diarrhea and vomiting.

The CDC said many pregnant women who are infected with H1N1 will not have a problem. However, for some, the illness might progress quickly and then, may be complicated by secondary bacteria infections, most likely pneumonia.

As for treatment, certain antiviral medications may help. Tamiflu and Relenza are believed safe for use in pregnant and breast feeding women.

However, a new report from the CDC revealed how one patient from Denmark is infected with a strain of H1N1 swine flu that it resistant to Tamiflu.
 
Re: H1N1 Flu Cluster: 5 Bay Area Pregnant Women

Obstetrician's offices, child birth classes...all of these situations, are very dangerous for these women.
 
Re: H1N1 Flu Cluster: 5 Bay Area Pregnant Women

This may be the first reported cluster of pregnant women infected with H1N1 in the country. One obstetrician who was consulted on all five cases told CBS 5 that he had never seen anything like this before.
This quote supports the hypothesis that Swine H1N1 is different from seasonal influenza. The CDC reports that roughly less than 6% of pregnant women get vaccinated for seasonal influenza so vaccination protection cannot account for the differences.

The news report in my opinion does a disservice to the readers, esp those who may be pregnant.
The CDC said many pregnant women who are infected with H1N1 will not have a problem. However, for some, the illness might progress quickly and then, may be complicated by secondary bacteria infections, most likely pneumonia
...
call your doctor, describe your symptoms and ask whether you need to be tested.
Actually the CDC guidelines instruct
Pregnant women who have suspected novel influenza A (H1N1) virus infection should be tested, and specimens from women who have unsubtypeable influenza A virus infections should have specimens sent to the state public health laboratory for additional testing to identify novel influenza A (H1N1
Pregnancy should not be considered a contraindication to oseltamivir or zanamivir use. Pregnant women might be at higher risk for severe complications from novel influenza A (H1N1), and the benefits of treatment or chemoprophylaxis with zanamivir or oseltamivir likely outweigh the theoretical risks of antiviral use
And their is also the important issue of fever management
Even though distinguishing the effects of the cause of fever from the hyperthermia itself is difficult, fever in pregnant women should be treated because of the risk that hyperthermia appears to pose to the fetus. Acetaminophen appears to be the best option for treatment of fever during pregnancy, although data on even this common exposure are also limited.

From the CDC guidelines on pregnanacy and H1N1 May 22
http://www.cdc.gov/h1n1flu/clinician_pregnant.htm
 
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