REPROSAIT 4 U

What is swine flu (H1N1)?

Swine flu (H1N1) is a highly contagious type of flu, with symptoms similar to seasonal flu. Swine flu has spread so quickly because it is a new virus, so most of us have not built up any immunity to it. The H1N1 virus is called swine flu because it is thought to originate from pigs.
Swine flu was first reported in Mexico in April 2009. Two months later, the World Health Organisation (WHO) raised a worldwide pandemic alert. This means that the disease has spread to many countries around the world.

How does swine flu spread?

Swine flu spreads in the same way as other flu viruses, through droplets from the coughs and sneezes of people who are infected. It spreads easily, particularly in enclosed spaces where there is close contact between people (WHO 2009).

What are the symptoms of swine flu?

Swine flu affects people differently. Most people who catch the virus have only mild symptoms (BMJ 2009a), but some people develop complications such as dehydration, pneumonia (an infection in the lungs) or difficulty breathing (NHS Choices 2009a).
There is evidence that pregnant women are four times more likely to develop complications from swine flu than non-pregnant women (DH 2009a). However, for most pregnant women the symptoms of swine flu are similar to ordinary flu. These are:

• sudden fever
• tiredness
• sore throat
• runny nose
• cough
• headache
• muscle and joint pain

Swine flu can also cause:

1. Acute abdominal pain
2. Diarrhoea
3. Vomiting (NHS Choices 2009b)

A fever caused by swine flu can be very high, reaching above 39 degrees C (102.2 degrees F), which is more than two degrees above your normal body temperature.

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

Pregnant women are not known to be more at risk of catching swine flu. However, if you do catch the flu you have a greater risk of developing complications (RCOG/DH 2009). This is because your immunity to infection is slightly lowered to stop your body rejecting your unborn baby. This also makes it particularly important that you are careful to protect yourself (see below) (CDC 2009b).

Can I be vaccinated against swine flu?

A vaccine for swine flu is available.

Pregnant women will be a priority in the early stages of the vaccination programme (NHS Choices 2009a).

The vaccine is given to pregnant women in two doses, with a three-week interval. It is recommended that all pregnant women have the swine flu vaccine (BMJ 2009b).

Are there other ways I can protect myself against swine flu?

You can reduce your risk of infection by avoiding unnecessary travel and keeping away from crowds. Wherever possible, try to avoid contact with people who have flu-like symptoms or you know have swine flu (Directgov 2009c).

Unless you have swine flu symptoms, you can carry on attending your antenatal appointments. You should also follow the hygiene rules recommended for everyone:

1. Cover your nose and mouth with a disposable tissue when you cough and sneeze and throw it away after using it (Directgov 2009b).
2. 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 passing the infection to your hand and will minimise spreading the disease (WHO 2009).
3. 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).
4. Don't touch your eyes, nose or mouth, because the germs spread very quickly (WHO 2009).
5. Wash your hands frequently. The virus can live for up to 24 hours on surfaces such as doorknobs and telephones (NHS Choices 2009a).
6. Eat a healthy diet, including plenty of fresh fruit, vegetables and wholegrain foods that will give you the minerals and antioxidant vitamins that help to fight infections (BDA 2009).

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).

Fever in early pregnancy is known to slightly increase the risk of neural tube defects, such as spina bifida, so it's important to control a high temperature. A very small number of pregnant women with swine flu develop complications, such as pneumonia, that can lead to miscarriage or their baby being born early. These risks are greater during the second and third trimesters of pregnancy.

The vast majority of pregnant women with swine flu make a full recovery and go on to have a healthy baby at full-term (HPA 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 (CDC 2009a).

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

If you're pregnant, call your doctor immediately to explain what's happening and tell her you are pregnant (CDC 2009b). Swine flu can be more severe in people with compromised immune systems, so she will also need to know if you, or anyone else in your family, have any other health problems (NHS Choices 2009b). Your doctor may prefer to give you a diagnosis over the phone, because the virus is highly contagious (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. If you are pregnant or your child is under one, this service will not be suitable for you and you will still need to speak to your doctor (Directgov 2009).
You can also call NHS Direct on 0845 4647 for advice.

How can swine flu be treated?

Fever is one of the symptoms of swine flu, so if you have a high temperature it's important to control it. Try your best to cool yourself down with a fan or tepid sponge. You can safely take paracetamol-based cold remedies (RCOG 2009). However, if you are pregnant, you should not take aspirin or anti-inflammatory drugs such as ibuprofen (NHS Choices 2009c).

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. It's recommended that pregnant women are offered antiviral treatment if it's suspected they have swine flu, even before it's been confirmed (RCOG/DH 2009).

Most pregnant women will be prescribed the antiviral drug Relenza. This antiviral is inhaled, so reaches the throat and lungs and does not build up in your blood stream (NHS Choices 2009d). If you have a health condition that makes it difficult for you to inhale a preparation, such as asthma, you will be offered Tamiflu (DH 2009b).
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).