If you’re pregnant, you’re at such high risk of complications such as pneumonia, dehydration and premature labor that you should be treated at once with the antiviral drug Tamiflu — even though it is not normally recommended in pregnancy. Because a positive test for the new H1N1 flu can take days Tamiflu should be given to any pregnant patient with flu symptoms and a history of likely contact with someone else with swine flu.
Up until now, swine flu has not proven to be much more dangerous than seasonal influenza. It is not clear whether pregnant women catch swine flu more often than other people, but in general, the flu poses additional risks for pregnant women.
Pregnancy weakens a woman’s immune system so that she is more likely to suffer pneumonia when she catches the flu. In previous flu pandemics, infection also raised the risk of a premature birth claims the CDC.
Pregnant women with asthma and some other health conditions are particularly at risk for complications.
The Center For Disease Control streeses the need to get the word out about the likely benefits of prompt antiviral treatment” 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. Little is known about whether they cut the chances of serious flu complications.
Tamiflu is not normally recommended for use by pregnant women because the effects on the unborn child are unknown, according to Roche Laboratories, it’s creator.
The CDC and the World Health Organization said case histories in Mexico and the United States suggested that pregnancy was emerging as a risk factor rivaling asthma, diabetes, immuno-suppression and cardiovascular disease.
American doctors are reluctant to prescribe flu drugs for pregnant women unless they develop severe symptoms such as pneumonia, and pregnant women often are reluctant to take any medication. A pregnant woman is at higher risk from any flu because hormonal changes depress the immune system to protect the growing fetus.
The CDC recommendation emerged as it was becoming clear that the epidemic in the U.S. would mirror the epidemic in Mexico and similar rates of severe illness should be expected.
By contrast, the outbreak across Europe is spreading more slowly because the Europeans aggressively treat every suspected mild case with Tamiflu, health officials confirmed.
The U.S. now has more than 3,000 confirmed cases — two-thirds in people under 18 — but only 116 hospitalizations. Officials said they thought that the actual number of infections was much higher, and that infections were still occurring.
CDC officials said the swine flu may seem to be mild now, but they worried the virus would mutate into something more dangerous.
There is much that scientists are still learning about this flu. Many people suffering from swine flu — even those who are severely ill — do not have fever, an odd feature of the new virus that could increase the difficulty of controlling the epidemic, according to Richard Wenzel, a leading American infectious-disease expert who last week examined cases in Mexico.
Another concern is that it will combine with the seasonal flu 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 is possible that the swine flu will become resistant to Tamiflu as well, health officials worry.