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Postexposure Prophylaxis in Pregnancy

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From Journalwatch.org

H1N1 Notes: Some Cases Without Fever; Postexposure Prophylaxis in Pregnancy

Pregnant women "in close contact" with those who have confirmed, probable, or

suspected swine-origin influenza A (H1N1) infection should receive a 10-day course

of zanamivir or oseltamivir, according to an MMWR Dispatch report on three pregnant

women with H1N1, one of whom died.

The report also recommends that pregnant women with confirmed, probable, or

suspected disease should receive antivirals for 5 days. Oseltamivir is "normally not

recommended for use during pregnancy," according to its label, but the CDC says the

drug is the preferred treatment for pregnant women during this outbreak. Oseltamivir

should be started within 48 hours of symptom onset.

In other flu-related news, the New York Times reports an "odd feature" of the H1N1

virus -- about one third of infected patients at two Mexican hospitals did not have

fever when screened. Given that many experts consider fever "the most important sign

of the disease," the Times says, its absence "could increase the difficulty of

controlling the epidemic."

Link to MMWR:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0512a1.htm

Link to CDC recommendations:

http://www.cdc.gov/h1n1flu/clinician_pregnant.htm

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