Swine flu in pregnancy

What is swine flu (H1N1)?

Swine flu (H1N1) is a highly contagious respiratory disease. Its symptoms are similar to seasonal flu. It is called swine flu because it is thought that the virus originally came from pigs. The reason why swine flu has spread so quickly is because it is a new type of flu virus, so we have not built up any immunity to it.

Swine flu was first reported in Mexico in April 2009. In June 2009, the World Health Organisation (WHO) raised a worldwide pandemic alert (NHS Choices 2009a). This means that the disease has spread to many countries around the world.

Experts think swine flu will become more widespread in the UK in the autumn and winter (NHS Choices 2009a).

What are the symptoms of swine flu?

flu affects people differently. Some people who catch the virus have only mild symptoms (BMJ 2009). But others can develop complications and in extreme cases swine flu can cause death (CDC 2009a). The symptoms of swine flu are similar to ordinary flu symptoms:

• sudden fever
• tiredness
• sudden cough
• headache
• muscles and joint pain

Swine flu can also cause:

• acute abdominal pain
• diarrhoea
• vomiting (NHS Choices 2009b)

A fever caused by swine flu can be very high. If you have swine flu your fever could go above 39 degrees C, more than two degrees above your normal body temperature.

How does swine flu spread?

Swine flu spreads in the same way as other flu viruses: through coughing and sneezing of people who are infected. Swine flu spreads easily, particularly in enclosed spaces where there is close contact between infected people and healthy people (WHO 2009).

You cannot catch swine flu by eating or preparing pork (FSA 2009).

I'm pregnant. Am I more at risk of catching swine flu?

If you're pregnant, your immunity to infection is slightly lowered to stop your body rejecting your unborn baby. So it's particularly important that you take sensible precautions to protect yourself (see below) (CDC 2009b).

Could swine flu affect my developing baby?

We know that with ordinary seasonal flu, your baby is well protected against the virus within your uterus (womb). Swine flu is a new strain of flu, so we don't yet know everything about it, but the risk of infection for your developing baby is not thought to be high (RCM 2009).

How can I protect myself against swine flu?

As a pregnant woman, you may want to reduce your risk of infection by avoiding unnecessary travel and keeping away from crowds. Unless you have swine flu symptoms, you can carry on attending your antenatal appointments.
You should also follow the hygiene rules recommended for everyone:

• Cover your nose and mouth with a disposable tissue when you cough and sneeze and throw it away after using it (NHS 2009).



• If you don't have a tissue to hand, cover your mouth with the inner part of your elbow when you cough or sneeze. This will avoid spreading the infection to your hand and will minimise spreading the disease (WHO 2009).



• After coughing and sneezing, wash your hands with warm water and soap. Rub both sides of your soapy hands for at least for 15 seconds and rinse with lots of water. If soap and water are not available, use alcohol-based disposable hand wipes or gel sanitisers (CDC 2009a).



• Don't touch your eyes, nose or mouth, because the germs spread very quickly (WHO 2009).



• Wash your hands frequently. The virus can live for up to 24 hours on surfaces such as doorknobs and telephones (NHS Choices 2009a).



• Eat a healthy diet, including plenty of fresh fruit, vegetables and wholegrain foods – a balance of these will give you minerals and antioxidant vitamins, such as vitamin C, which help to fight infections (BDA 2009).

How long do people stay contagious?

People who have the swine flu virus can be contagious for up to seven days after the onset of the illness. Children, especially younger ones, may be contagious for longer periods (CDC 2009a).

What should I do if I or somebody in my family shows symptoms of swine flu?

If you're pregnant, call your doctor immediately and explain what's happening (CDC 2009b). Tell her that you are pregnant and whether you have any other health problems. Swine flu can be more severe in people with compromised immune systems (NHS Choices 2009b). Because the virus is highly contagious, your doctor will provide you with a diagnosis over the phone (NHS Choices 2009a).

If you think someone in your family has swine flu, log onto the National Pandemic Flu Service, which can dispense antiviral drugs. This service will not be suitable for you if you are pregnant and you think you have the flu. You will still need to speak to your doctor (Directgov 2009).

You can also call NHS Direct on 0845 4647 for advice.

Is there any treatment for swine flu?

There is no cure for swine flu, but antiviral drugs will relieve the symptoms and help you to recover faster. They will also reduce the likelihood of you developing complications. Most pregnant women will be prescribed the antiviral drug Relenza, which is inhaled. This way it reaches the throat and lungs and does not build up in your blood stream.

The risk of taking antiviral treatments in pregnancy is extremely small, and much smaller than the risks posed by the symptoms of swine flu (NHS Choices 2009a).

If you have a fever, you can safely take paracetamol-based cold remedies. However, you should not take anti-inflammatory drugs such as ibuprofen.

Is there a vaccine for swine flu?

Can I be vaccinated against swine flu?

A vaccine for swine flu is to be released in the autumn. Pregnant women will be a priority in the early stages of the vaccination programme (NHS Choices 2009a).