Federal health officials put out new guidelines Tuesday that say the flu medicines Tamiflu and Relenza should only be used to treat people who are sick with the flu and at high risk for complications.
The new advice tries to close a door that government doctors had left open in May. Back then, they didn’t rule out sometimes using the drugs to stop swine flu’s spread and prevent illness even in children who had no symptoms.
Now that swine flu is so common, health officials say the medicines should be reserved for people at higher risk of complications.
Children and the elderly are at "high risk" of serious complications from swine flu. But pregnant women are among the most vulnerable.
"We don't know the full epidemiology of swine flu because it's so new, but the small literature we do have seems to point to pregnant women as disproportionately affected by the virus," says Dr. Cynthia Gyamfi, assistant clinical professor of obstetrics and gynecology at Columbia University Medical Center.
The first swine-flu fatality in the U.S., on May 5, was a pregnant woman, Judy Trunnell, 33, of Texas.
"As the uterus grows during pregnancy, it compresses the diaphragm and the area where the lungs are, and there is less air movement in lungs, so any type of infection can fester longer when you're pregnant," says Gyamfi, who specializes in high-risk obstetrics.
With the President's Council of Advisers on Science and Technology predicting the resurgence of swine flu could kill as many as 90,000 Americans, mommies-to-be need to be extra-vigilant about the coming flu season, according to New York's top baby docs:
1. "Wash your hands, wash your hands, wash your hands," says Dr. Amos Grunebaum, director of obstetrics at New York-Presbyterian/Weill Cornell Medical Center. "We're all on top of each other in New York - that's how our patients got pregnant in the first place. We're on the subway, the bus, everything is crowded, and that increases your risk of becoming infected." Grunebaum recommends taking in the fresh air in Central Park and some loops around the reservoir in lieu of unnecessary trips undergound.
2. If you have a fever or think you have any symptoms, call your doctor and get treated immediately with antivirals like Tamiflu and the flu vaccine. "Mothers should keep in mind that there will be two vaccines for the next flu season - one for swine flu specifically, and one for the strain of flu that we think will be the most common. They should get both vaccines," says Gyamfi. And time is of the essence. "If mothers develop any flu-like symptoms - cough, sore throat, runny nose or fever - they should get treated with Tamiflu immediately, because it's most effective when started within 24 to 48 hours after symptoms begin," adds Grunebaum.
3. Avoid sick people. If a pregnant women is even exposed to someone who has H1N1, Grunebaum recommends taking a prophylactic dose of Tamiflu without waiting for culture results. If you are sick, Gyamfi advises determining your temperature before you take Tylenol to treat it, so you can get a sense of how sick you are and tell your doctor.
Thursday 20th August 2009 By: Nursing In Practice 15 Minutes Ago
The latest swine flu patient figures are expected to show a slowing of new cases of the disease.
Chief Medical Officer Liam Donaldson's last update revealed there were 25,000 new cases, compared with 30,000 and 110,000 in the previous two weeks.
The number of new cases of swine flu should continue to decline while schools and universities are closed, according to experts, but numbers may rise sharply again when term time begins.
The eventual number of deaths is estimated to be between 55,000 and 750,000.
A total of 44 people in England have been confirmed as dying after contracting swine flu, while another five have died in Scotland.
Sir Liam revealed that people in priority groups would begin receiving vaccinations in October.
However, doctors have reportedly been alerted over fears that Tamiflu could put increase some patients' risk of suffering a stroke.
The Medicines and Healthcare products Regulatory Agency (MHRA) has raised concerns that the drug may interact with warfarin, which is taken to thin the blood.
