Birdflu Mailing List: Whenever you communicate with a pregnant women

[William Weir (wweir1]

As part of our emergency preparedness, I wonder whether it would be
appropriate to find a time to ask each woman whom you learn is pregnant,
"Have you had your vaccination against flu yet?  That is, the 2009 H1N1
flu?"

And if appropriate, give her the information that "the CDC (US Centers for
Disease Control and Prevention) has reported that pregnant women are more
likely to have severe complications from this virus.and have urged doctors
to give the vaccine to every pregnant women."

People in Minnesota are still dying from this new strain of flu (2 reported
last week), even though news coverage is minimal.

The 3/26/10 CDC news release can be found at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5911a1.htm?s_cid=mm5911a1_e

The first paragraph states,
"Pregnant women are at increased risk for severe illness and complications
from infection with seasonal influenza (*1--3*) and 2009 pandemic influenza
A (H1N1) (*4--6*). To characterize the severity of 2009 H1N1 infection in
pregnant women, the New York City Department of Health and Mental Hygiene
(DOHMH) conducted active and passive surveillance for cases of 2009 H1N1
infection in pregnant women requiring intensive care. This report summarizes
the results of that surveillance, which found that, during 2009, 16 pregnant
women and one who was postpartum were admitted to New York City
intensive-care units (ICUs). Two women died. Of the 17 women, 12 had no
recognized risk factors for severe influenza complications other than
pregnancy (*7 <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5808a1.htm>*). All
17 women received antiviral treatment with oseltamivir; however, treatment
was initiated â2 days after symptom onset in only one woman and was begun â5
days after symptom onset in four women. Because initiation of antiviral
treatment â2 days after onset is associated with better outcomes (*5,6*),
pregnant women should be encouraged to seek medical care immediately if they
develop influenza-like symptoms, and health-care providers should initiate
empiric antiviral therapy for these women as soon as possible, even if >2
days after symptom onset. Health departments and *health-care providers
should educate pregnant and postpartum women regarding the risks posed by
influenza and highlight the effectiveness and safety of influenza
vaccination. Obstetricians and other health-care providers should offer
influenza vaccination to their pregnant patients."
*
Whether or not she accepts vaccination (either an injection or a mist to
breathe in), she also needs to know, as soon as she has any flu symptoms, to
ask her doctor for antiviral medicine. such as Tamiflu.  The antiviral works
by preventing spread of the virus from a few cells to many more cells (which
increases severity) so the sooner the better to start taking the antiviral.


If she may be in contact with other persons carrying the virus, her doctor
may prescribe a smaller preventative dose.

Bill Weir
Chair, FUS Comte. for Emergency Preparedness.