HSE issues Information and medical advice about influenza A(H1N1) for pregnant women and women who are breastfeeding

HSE
Information and medical advice about influenza A(H1N1) for pregnant women and women who are breastfeeding
Version 1.0 : 26.5.09
What is influenza A(H1N1)?
Influenza A(H1N1) is different from the ordinary or seasonal flu that occurs every winter.
• It has spread rapidly in the Americas.
• It could be highly infectious
• It may affect large numbers of people
• It may cause more severe illness than ordinary flu
• It may cause more deaths than ordinary flu
• It may occur in two or more waves several months apart – with each wave possibly lasting weeks or months
Are there people at higher risk of complications?
Some people are at higher risk of complications from flu. They may require
additional treatment or monitoring.
This group includes people with chronic heart or lung disease, diabetes, liver and kidney disease, people receiving cancer treatment and whose immune system is impaired due to disease or treatment (immunocompromised). It also includes children under 3 years and pregnant women.
What can people do to protect themselves from influenza A(H1N1)?
Preventing the spread of germs is the single most effective way to slow the spread of influenza.
1. Wash your hands often with soap and water, and especially after coughing and sneezing and before eating. Alcohol-based hand cleaners (minimum 60% alcohol) are also effective
2.Avoid unnecessary close contact with people who have influenza
3.Avoid touching your eyes, nose or mouth with your hands – germs spread this way
4.Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.

How will I know if I have got influenza A(H1N1)?
You will have the same symptoms as if you had ordinary flu but they will probably be sudden, and may be severe. They may include:
• Temperature over 38ºC/100.4ºF and some of the following:
• Dry cough • Sore throat
• Headache • Runny nose
• Severe weakness and fatigue • Vomiting / diarrhoea
• Aching muscles and joints
These can lead to complications some of which may be severe.
What should a pregnant woman do if she thinks she may have influenza A(H1N1)?
Anyone who is pregnant needs to have an urgent assessment by their doctor.
•Contact your GP by phone and follow his or her instructions.
•Discourage any visitors
•Take medicines such as paracetamol to reduce the symptoms
•Drink plenty of fluids
•Most people with flu will recover within a few days.
•Stay at home for up to 7 days or until you fully recover (whichever is the longer)
•If you need to go to a doctor’s office or to an emergency room, please telephone before you go and tell them that you think you might have influenza A(H1N1). When you are there cover your mouth and nose with a facemask or a cloth; make yourself known to staff. Do not sit in the waiting area with other patients.
When should a pregnant woman get emergency medical care?
If you have any of these signs, contact your doctor right away:
•Shortness of breath at rest or while doing very little
•Painful or difficult breathing
•Coughing up bloody sputum
•Drowsiness, disorientation or confusion
•Sudden dizziness
•Severe or persistent vomiting
•Decreased or no movement of your baby
•Fever for 4-5 days and not starting to get better (or getting worse)
•Starting to feel better then developing high fever and feeling unwell again
Is there a vaccine against influenza A(H1N1)?
No. There is currently no vaccine for influenza A(H1N1). The vaccine given for seasonal flu does not protect against influenza A(H1N1).
Is there treatment against influenza A(H1N1)?
Yes. The influenza A(H1N1) virus is sensitive to antiviral drugs. These medicines may reduce the severity of the illness. Treatment is most effective if started within 48 hours of symptom onset, but may also be given to very sick or high risk people (like pregnant women) even after 48 hours.
How else should pregnant women prepare for the possibility of spread of the influenza A(H1N1) virus?
Certain pregnant women are at higher risk of complications from flu – these include women with chronic heart disease, chronic lung disease, diabetes, liver and kidney disease, receiving cancer treatment and whose immune system is impaired due to disease or treatment (immunocompromised).
If you are one of these women you should consult your doctor and make sure all your vaccinations are up-to-date. Seasonal influenza vaccine should be used as advised and when available.The seasonal influenza vaccine is considered very safe in pregnancy.
What if I get this new virus and I am pregnant?
We do know that pregnant women are more likely to get sick than others and have more serious problems with seasonal flu. These problems may include early labour or severe pneumonia. We don’t know if this virus will do the same, but it should be taken very seriously.
Can I take antivirals if I am pregnant?
Your doctor will decide if you need antiviral drugs. There is little information about the effect of antiviral drugs in pregnant women or their babies, but no serious side effects have been reported.

Is it ok to breastfeed my baby if I am sick with this virus?
•A mother’s milk is made to fight diseases in her baby. This is really important in young babies when their immune system is still growing.
•Do not stop breastfeeding if you are ill. Breastfeed early and often. This will help protect your baby from infection.
•Be careful not to cough or sneeze in the baby’s face.
•Wash your hands often with soap and water.
•Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby.
•If you are too sick to breastfeed, pump if possible and have someone give the expressed milk to your baby.
Is it OK to take antivirals while breastfeeding?
There is little information about the effect of antiviral drugs on breastfed babies, but no serious side effects have been reported. Your doctor will decide whether antivirals are right for you.

Telephone
Further Information is available from the HSE Flu Information Line.
The Flu Information Line is available 24 hours a day and is your primary source of information on influenza A(H1N1).
Freephone 1800 94 11 00
Websites
The HSE’s Website will be kept updated every day with latest information and advice. Check it often.
Health Service Executive
www.hse.ie
Department of Health and Children
www.dohc.ie
Information for Health Professionals will be on
www.hpsc.ie

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