H1N1 Update

1 10 2009

Dr. Anne Schuchat of the CDC spoke today on H1N1 infections, vaccines, and antivirals.  Here are some notes to catch us up on the news of the day:

  • There’s substantial flu illness in most of country – in most all of the states, which is unusual for this time of year.
  • As of late August, there were about 100 pregnant women in the U.S. who required ICU hospitalization for H1N1, and 28 had died.
  • Antiviral medications can be important for pregnant women.  Getting vaccinated is an important way to protect oneself, although pregnant women cannot use the live attenuated vaccine, only the inactivated vaccine, so no nasal spray, only shots.
  • In the general population, bacteria have had an important role in some of the fatal cases.  Of the 77 cases of H1N1 deaths that have been reviewed, about one-third could have been prevented with a pneumococcal vaccine.  Check with your providers to see if this is something you or your loved ones should get.
  • HHS Secretary Sebelius released to the states 300,000 courses of liquid Tamiflu for children, and each state that needs their portion of that supply will receive it.  Texas and Colorado have already received theirs.  The expiration dates on some of this product have passed, but the FDA tested them and determined they were safe and effective and extended the expiration dates.
  • People with severe illness can benefit from antivirals, and those with symptoms whose underlying conditions may cause a more serious course of H1N1 disease should get antivirals.   See Flu Essentials at flu.gov for warning signs of serious illness.
  • The H1N1 vaccine effort has moved into the implementation phase.  States and large cities that are part of the program started to place orders yesterday, with 25 sites placing orders for about 600,000 doses of vaccine.
  • In the future, every Friday, CDC will provide updates through Wednesday of that week on how much H1N1 vaccine is available, how much has shipped out, and to what location it has shipped.
  • Right now they are shipping out the live attenuated vaccine only.  Rumors are going around that healthcare workers cannot receive the live attenuated, but if they are under 50 years of age with no chronic medical conditions, they should be able to receive it.
  • Dr. Schuchat made it clear that for H1N1 vaccine manufacture, safety was the top priority.  No corners were cut in production.  It was produced exactly as seasonal influenza vaccine is produced with even more clinical trials.

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H1N1 and Pregnancy

13 05 2009

Some pregnant women are experiencing severe complications from H1N1 infection, including pneumonia, dehydration and premature labor.

In otherwise healthy individuals, flu of any strain or type can be harder on pregnant women than women who are not pregnant.

CDC is recommending that providers immediately start treating with antivirals if they suspect a pregnant woman in their care is infected with H1N1.

The worrisome part to this – and there’s always a worrisome part – is that not a lot of testing has been done to see how these drugs will affect the pregnant woman or the fetus.

Most providers don’t like to prescribe meds for pregnant women and many of their patients don’t want to take meds while pregnant.

But, the risk of harm appears to be greater with infection than with taking the meds, so please consider taking antivirals if you suspect you have influenza.

If you’re pregnant and you think there’s a remote chance you might be infected with H1N1, call your provider immediately.

Dr. Anne Schuchat, Interim Deputy Director for Science and Public Health program at CDC, said yesterday that, “…experts who have looked into this situation really strongly say that the benefits of using antiviral drugs to treat influenza in a pregnant woman outweigh the theoretical concerns about the drugs.”