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Swine flu (H1N1) and pregnancy

You know, there is a joke that has been doing the rounds for years, meaning it is a lot older than swine flu. However, the gist of it is still true and applicable to Swine Flu. It goes like this:


“How can I tell if my vomiting is morning sickness or the flu? If it is the flu, you will get better”.


Well, even if it was morning sickness, you will get better – eventually. Like I said before, the unintended message of the joke is true: With flu, even swine flu, the expectation is that you will get better. That is the case in the vast majority of cases.


There is, however, emerging evidence that pregnant women may be more susceptible to the swine flu virus than the average population. In the United States, up to the end of July 2009, there had been 305 swine flu related deaths. Details of the majority of them (266) were available and 6% of these were among pregnant women, the majority being healthy and in the last trimester. The risk of hospitalisation for pregnant women who catch the virus has also been running at four times the average. Pregnancy is therefore legitimately regarded as a risk factor.



The Influenza virus

There are many influenza viruses. The influenza viruses are different from the viruses that cause the common cold or childhood respiratory diseases.  Many of them cause a seasonal illness, typically in winter. The seasonal outbreaks of flu are responsible for deaths of hundreds of thousands of vulnerable people, usually the elderly; every year.



Influenza Pandemics

What do we mean when we talk of a pandemic? A pandemic is when an infection spreads to many countries in most or all parts of the world. AIDS is probably the most well known current pandemic.

The Influenza viruses have a tendency to evolve and sometimes produce strains that are deadlier and spread rapidly worldwide.

The Spanish Flu Pandemic is probably the deadliest influenza pandemic in history. It started in 1918 and eventually came to an end in 1920. It is estimated to have killed between 50 and 100 million people worldwide. Significantly, this pandemic was caused by the same virus strain (H1N1) causing the current swine flu.

There were two more influenza pandemics in the 20th century, the Asian Flu pandemic in 1957-58 which killed almost 2 million people and the Hong Kong Flu pandemic responsible for 1 million deaths. This was in 1968-69.















The Swine Flu Pandemic

The current influenza pandemic sweeping the globe started in Mexico among pigs (hence the name swine flu) in early 2009. It soon spread to humans creating understandable panic. The initial response by governments in the developed world was to try containment measures to prevent spread. This is the tactic that was applied for the ‘bird flu’ outbreak in 2006-2007 mainly in South East Asia. Bird flu is caused by a different virus (H5N1). Containment measures did not work for swine flu.


As mentioned earlier, swine flu is caused by the H1N1 influenza virus strain.



Swine Flu (H1N1) symptoms:

One of the biggest problems for making a correct timely diagnosis for swine flu is the fact that the symptoms are non-specific and severity quite variable. The symptoms include:


§ Fever: Temperature of 38°C or above. Sometimes the fever is low-grade.

§ Joint or limb pains

§ Runny nose

§ Sore throat

§ Cough

§ A feeling of fatigue

§ Vomiting (remember the joke above)

§ Diarrhoea

Not everyone with the infection will have all of these symptoms.



Those at increased risk for Swine flu

Everybody can contract swine flu. The groups identified to be at possible increased risk of severe disease include those with:


§ Chronic lung disease including asthma

§ Chronic heart , kidney or liver disease

§ Chronic neurological diseases

§ Diabetes

§ Suppressed immunity

§ The elderly; those aged above 65. However, so far only about 1% of confirmed patients have been in this age group.

§ Young children under 5

§ Pregnancy


How swine flu spreads:

This is a typical aerosol spread type of infection. It is passed from person to person through coughing and sneezing. The droplets that spread into the air as a result of these actions will contain the virus and once inhaled, the infection will be acquired. The virus can also be acquired through handling normal surfaces such as door handles, walls, combs, work surfaces such as computer keyboards etc.




Continues next page

Pandemic
Virus Type
Year
Number of dead
Spanish flu
H1N1
1918-1920
50 - 100 million
Asian flu
H2N2
1957-1958
1.5 - 2 million
Hong Kong flu
H3N2
1968-1969
1 million
pregnancy is a risk factor for swine flu