A new strain of pandemic (wide spreading) influenza, H1N1, is of major concern for pregnant and breastfeeding women this year due to the fact that it is airborne. It is being transferred person to person via droplets released in the air after an infected person coughs or sneezes, which allows the virus to enter the body through the nose or mouth. Following extensive testing, it was discovered that this virus is a combination of genes from swine, avian and human flu. H1N1 first emerged in April 2009 and initial indications showed that unlike seasonal flu, which as a rule affects primarily seniors and children, it was also prevalent in healthy, young adults. Moreover, pregnant women in their second or third trimester may be at greater risk for complications if they come down with the virus and for new (first time) moms within four weeks of birth.
Symptoms
H1N1 shares similar symptoms with seasonal flu. Early symptoms of either flu may include, but are not limited to, fever and cough followed by some or all common indicators such as fatigue, sore throat, muscle/head aches and a runny nose.
Serious symptoms may include difficulty breathing or shortness of breath, chest pain, severe or unceasing vomiting, sudden dizziness, fever of 39 degrees C or above, intense abdominal pain and low blood pressure.
Recommendations for Pregnant and Breastfeeding Women
If a pregnant woman contracts H1N1, there is a possibility it could result in severe symptoms requiring hospitalization, early delivery or, in the worst case scenario, miscarriage.
Health authorities recommend that pregnant women be vaccinated for not only H1N1, but seasonal flu as well. Talking with health care providers is advised when trying to make a decision regarding what is best for an individual.
In addition, it is suggested that women who are breastfeeding receive the adjuvanted H1N1 flu shot to protect the health of both mother and infant.
Two Types of Vaccine: Unadjuvanted and Adjuvanated
There are two types of H1N1 vaccines available: unadjuvanted and adjuvanted.
Included in an adjuvanted vaccine is a substance that boosts the immune system, thereby increasing the individual’s response to the vaccine. There is no booster element in an unadjuvanted vaccine.
The Canadian Public Health Authority recommends pregnant women receive the unadjuvanted vaccine if the flu virus is not yet prevalent in the community, simply because there is more safety data currently available. If the vaccine is not available and H1N1 occurs in the community women more than 20 weeks pregnant are being urged to talk with their doctors regarding getting the adjuvanted vaccine. With seasonal flu, it is known if the fetus is protected against the virus in the womb. Because H1N1 is a new strain, at present, there isn’t sufficient data to determine whether or not the virus is able to cross the placenta.
What to Do if You Develop Symptoms
Contact your health care provider immediately. Do not accept a diagnosis of "you have a mild case of the flu." Pregnant women must be proactive when it comes to their own health and the safety and health of their unborn child.
Precautionary Measures
Because H1N1 germs are airborne, they can come to rest on hard surfaces, like doorknobs and counters and they are then picked up on hands and transferred to the respiratory system by touching the face. Germs are especially rampant in public areas such as malls, schools, supermarkets, public transit and walk-in-clinics, to name a few.
While life can’t come to a halt because of flu season, and coming in contact with objects when out in public is unavoidable, precautionary measures such as the following can be taken to lessen the transfer of germs:
- Avoid touching your face or your child’s face without disinfecting your hands first.
- Carry alcohol-based wipes, in a pocket or purse, to clean handles of shopping carts, water taps and doorknobs prior to touching them.
- Frequent and thorough hand washing with anti-bacterial soap, and the use of an alcohol based hand sanitizer (alcohol content of between 60 to 90 percent) when washing hands is not possible can effectively remove the virus from hands.
- Be certain to wash hands prior to breastfeeding, preparing food, taking and/or administering medications or removing/inserting contact lenses. Always wipe hands with a clean towel or paper towel.
- Wash hands immediately after preparing food, using the toilet or changing a diaper, blowing your nose or your child’s nose and taking care of an infected person.
- Avoid placing purses, diaper bags and backpacks on floors when in public areas. Do not place said items on countertops, beds or any other places in the home where germs may be transferred and wipe them down or wash them frequently.
- Sneeze or cough into your sleeve instead of your hand, this will prevent germs from spreading.
- Disinfect all hard, common surfaces at home including doorknobs, counters, floors, countertops and baby changing area.
NOTE: There is no evidence that wearing a surgical mask will protect against coming in contact with H1N1 germs as they do not provide an effective barrier. On the contrary, if a mask is removed improperly any bacteria on the outer side of the mask will be transferred to the hands and face.
