Evidence of swine flu risk to pregnant women rises

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Evidence of swine flu risk to pregnant women rises; experts urge early treatment

http://www.google.com/hostednews/canadianpress/article/ALeqM5jiEhxWUiH_XUQapgsZTTYelXFQKw

Remember that the CDC is now recommending special considerations for pregnant HCW. Most hospitals and health care facilities have not yet implemented those guidelines. They might not if no one mentions this to Risk Management. Feel free to copy this article and show it to RM with the CDC guidelines. I am going to be doing this also.

If you are pregnant and you get sick, take the Tamiflu. It is safer than not taking it.

First a link to the gudelines, then the article:

http://www.cdc.gov/h1n1flu/guidance/pregnant-hcw-educators.htm

There are mounting and troubling signs that swine flu and pregnancy don't mix well.

Six pregnant women in Manitoba are reportedly on ventilators because they are severely ill with the virus.

And at least two pregnant women in the United States have died of swine flu complications after delivering babies by C-section.

A pregnant teenager in the Dominican Republic died, as did a pregnant woman in Scotland.

A woman in St. Theresa Point, a First Nations community in Manitoba, miscarried after contracting swine flu.

Humankind's relationship with the new swine H1N1 virus is still in its infancy. But people who've studied the issue of pregnancy during flu pandemics don't like the signs they are seeing. Dr. Denise Jamieson, an obstetrician-gynecologist with the U.S. Centers for Disease Control's division of reproductive health, says she finds the evidence to date "very unsettling."

"I am concerned about this," Jamieson said in an interview from Atlanta.

"There does seem to be increased severity in pregnancy. We don't have hard and fast numbers but there are enough reports that are concerning."

Data released by the CDC last month said at that point, 17 per cent of Americans hospitalized for severe swine flu infections were pregnant women.

A report a couple of weeks back in the World Health Organization's journal, Weekly Epidemiologic Record, noted of 30 swine flu patients hospitalized in California, five were pregnant women. Of those, two developed severe complications - spontaneous abortion and premature rupture of membranes.

...the fatality rate was higher in pregnant women during the 1918 and 1957 pandemics, though not the milder pandemic of 1968.

"If we base it on what we know of the 1918, 1957 pandemics, what we know about pre-existing antibody levels to swine influenza in the population, based on that I would say for this particular virus, pregnant women may suffer more serious consequences, especially in the third trimester," she said.

"And they should probably seek care early if they have influenza-like illness."

Studies done after the disastrous 1918 Spanish flu - which took its heaviest toll on young adults - showed astonishing death rates among pregnant women, said Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota.

Skowronski's review paper suggests there were also very high rates of spontaneous abortions during that pandemic - 26 per cent in pregnant women who became infected and 52 per cent among those who went on to develop pneumonia from their infection.

Osterholm explained pregnancy is a precarious state for a woman from an immunological point of view. In order that the mother's body does not reject the fetus, part of the immune system has to be effectively dialled down.

Other factors are also believed to come into play, including reduced lung capacity, Jamieson added.

She said that while the CDC doesn't yet have firm numbers, they are hearing that some pregnant women are reluctant to take antiviral drugs when they are diagnosed with swine flu. In some cases, their physicians share the reluctance.

Jamieson said given the risk swine flu poses to pregnant women, any who feel they may have contracted it should seek care quickly and should tell their doctor about potential exposures to people who had the virus. And they should take the antiviral drugs, she said.

"The message we're trying to get out is: 'Don't delay. If you suspect influenza, initiate antiviral therapy appropriately even before you get the testing back," Jamieson said.

"We definitely feel like in a situation like this, the benefits outweigh the risks of giving antiviral medication."

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Specializes in Acute Care Psych, DNP Student.

I would hope pregnant women will be given top priority when the vaccine comes out. We know there will not be enough vaccine to go around.

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I would hope pregnant women will be given top priority when the vaccine comes out. We know there will not be enough vaccine to go around.

I would hope so. But, before the vaccine comes, we still need to protect them as much as possible. Most do not even know that they are at increased risk. The vaccine is not going to be available for some time. I would guess at least 4 months maybe more...

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Thank you, Thank you, so important.

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UK: More on the first British H1N1 death

http://crofsblogs.typepad.com/h5n1/2009/06/uk-more-on-the-first-british-h1n1-death.html

A new mother with swine flu died last night - the first such death in Britain. The 38-year-old, who has not been named, had given birth nearly three months prematurely at the Royal Alexandra Hospital in Paisley, near Glasgow.

Medics were last night fighting to save the premature baby.

The Scottish woman had been gravely ill in hospital suffering from the influenza H1N1 virus. She had underlying health problems and was one of ten swine flu cases in hospital in the greater Glasgow area.

A 26-year-old nurse who helped treat her at the city's Southern General Hospital has also contracted the virus.

It is the first death in the UK of someone with swine flu since the outbreak began-and the first outside the Americas.

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Specializes in Too many to list.

I am going to list all of the pregnant cases that I know of as having been affected by swine H1N1. These are in addition to the Scottish woman mentioned in the last link and the 6 women on vents in Manitoba, already mentioned in this thread. I want to keep track of these cases in one spot.

Judy Trunnell of Allen, Texas, had an emergency C-section and died.

http://www.usatoday.com/news/health/2009-05-05-swine-flu-death_N.htm

http://www.flutrackers.com/forum/showpost.php?p=235701&postcount=7

There were five pregnant women in this report, and two miscarried.

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/may1909hospital-jw.html

Jessica Avalo of El Paso, Texas had an emergency C-section and died.

http://www.kfoxtv.com/news/19606453/detail.html

Caitlin Huber of Chicago, Illinois, died in childbirth.

http://journalstar.com/articles/2009/06/02/news/local/doc4a259e029aa41193538839.txt

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Altamonte Springs, Florida

http://www.wesh.com/health/19836231/detail.html

I find it so bizarre that the reporter says it is unknown if this poor woman traveled recently as if this disease has not been in the US since April...

A pregnant woman has died of swine flu, or H1N1, at Florida Hospital Altamonte, according to the Seminole County Health Department.

Seminole County health officials said that the 30-year-old mom-to-be had multiple conditions that put her in a high-risk category.

It is unknown if the woman traveled recently.

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Buenos Aires, Argentina

http://www.buenosairesherald.com/BreakingNews/View/4824

There were two young pregnant women that died in Buenos Aires.

A pregnant woman died after contracting the virus in Buenos Aires province.

The 24-year-old woman had been hospitalized at the Güemes clinic in the district of Luján, after she showed symptoms of the illness.

Sources said the mayor of Luján, Graciela Rosso and the local Health Secretary, Héctor Ruffinelli, will give a press conference this afternoon to comment on the details of the case.

Media in Buenos Aires reported that another pregnant woman died. The 19-year-old woman had been hospitalized in Larcade Hospital in San Martin district and died on Tuesday morning, Malbrán Institute is analyzing her test to confirm if she died of H1N1 virus.

http://www.flutrackers.com/forum/showpost.php?p=255389&postcount=49

Here is a translation of an article about these two cases.

...a young pregnant 24-year-old native of General Rodriguez, who died in the clinic Güemes victim of influenza. Despite the situation, the doctors managed to save the baby, who at this time remains stable.

asures to take to the increase in deaths.

On the other hand, hopes the results of swabs done to another pregnant girl, 19, who died on Wednesday at the Hospital Doctor Lacarde, San Miguel (Buenos Aires province), because of pneumonia complications at a table that could be compatible with influenza A H1N1. From the Secretary of Health of the local council said the newspaper Crítica that the results of samples sent to the Institute Malbrán be ready at noon today.

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Spain

http://crofsblogs.typepad.com/h5n1/2009/06/spain-two-grave-cases.html

This is from a translation. With both asthma and a pregnancy, the outcome could be dismal.

Por su parte, fuentes de la Consejería de Sanidad de la Comunidad de Madrid han confirmado a elmundo.es que "una mujer de 19 años embarazada de 28 semanas está ingresada en la UCI del hospital Gregorio Marañón con gripe A. Se trata de una paciente asmática que ha desarrollado una neumonía".

Meanwhile, sources in the Health Council of the Community of Madrid have confirmed to elmundo.es that "a 19-year-old woman, in the 28th week of pregnancy, is in intensive care at Gregorio Marañon Hospital with influenza A. She is being treated for asthma that has developed into pneumonia."

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Rosario, Argentina

http://www.flutrackers.com/forum/showpost.php?p=257778&postcount=7

Reported two other deaths in Rosario by influenza A

Two other people died today in Rosario because of influenza A, which will join the four fatalities in the city.One victim was pregnant, died today, while the other was an immunocompromised individuals.

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Specializes in OB, HH, ADMIN, IC, ED, QI.
I would hope pregnant women will be given top priority when the vaccine comes out. We know there will not be enough vaccine to go around.

Read more about the new method of reproducing vaccines. This process doesn't use eggs, an added advantage for persons allergic to them. It is faster, and allows sufficient amounts of vaccine within months, for every person in the USA. The vaccine is being manufactured here.

Try looking more toward the positive, less on the negative.

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Spain

http://crofsblogs.typepad.com/h5n1/2009/06/spain-two-grave-cases.html

This is from a translation. With both asthma and a pregnancy, the outcome could be dismal.

http://www.pr-inside.com/first-swine...n-r1353667.htm

I believe that the following link is referring to the same young woman although they have listed her age as a year older than the translation above. The outcome is that another emergency c-section had to be done to save the baby of a young woman dying of swine flu...

Originally Posted by http://www.pr-inside.com

www.pr-inside.com][/url]

A 20-year-old woman in Madrid became Spain's first swine flu fatality on Tuesday, dying a day after giving birth to a healthy child via Cesarean section, the Health Ministry said.

The Moroccan woman had a history of asthma and died of a respiratory disease caused by swine flu, the ministry said.

She was 28 weeks pregnant and doctors performed a C-section on Monday. The ministry says the baby is healthy.

The woman was hospitalized in Madrid on June 15.

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