pregnancy raises flu risk

[Guest guest]

Correct me if i'm wrong, but i thought you were less suceptible to infections

when you're pregnant??

http://aolsvc.health.webmd.aol.com/content/Article/78/95743.htm?pagenumber=1

Pregnancy Raises Flu Death Risk

Vaccination Advised for Nearly All Pregnant Women

By  DeNoon

WebMD Medical News  Reviewed By   , MD

on Wednesday, December 10, 2003

Dec. 10, 2003 -- What happens if a pregnant woman gets the flu? What about

the flu vaccine?

To answer this question and others, WebMD turned to three experts:

Weiss, MD, MPH, instructor of obstetrics and gynecology at Emory University in

Atlanta; , MD, director of infectious diseases at University

Hospital in Denver; and Dennis Clements, MD, PhD, professor of infectious

diseases

and pediatrics at Duke University Medical Center. Clements also serves as

medical director of PDC Primary Care.

Question: Is flu worse for women when they're pregnant?

Weiss: Observational studies show there might be an increased risk of severe

disease or death. One study showed that even though the risk of death from flu

is quite low, that risk is nine times higher when a woman is pregnant. But

that's still not a big number.

Most viral illnesses last three times longer in pregnant women than in women

who aren't pregnant. The average case of flu may run its course in three or

four days. But a pregnant woman may be sick for much longer. Our biggest risk

with any flu is viral pneumonia. And because of the demands of pregnancy and a

weakened immune system, the pneumonia is that much more dangerous for pregnant

women.

During past worldwide pandemics of flu -- and thank goodness there is not one

of those going on this year -- 30% to 50% of pregnant women who got viral

pneumonia died. That is about three times higher than same-age nonpregnant

women.

So there is a chance of more severe disease, but for the average pregnant

woman the flu will just last longer. They won't have worse muscle aches or worse

fever or a worse cough. There's just more chance of the flu getting worse than

in nonpregnant women. "

: Flu has historically been more severe in pregnant women. During

pregnancy there is a reduction in the strength of the immune system. So flu is

potentially more dangerous in pregnant than in nonpregnant women. I think just

as

patients with asthma or emphysema may have a higher chance of severe flu, you

might see that in pregnant women as well. But I don't see it as having

unusual manifestations.

Question: If a pregnant woman gets the flu, is her unborn child at risk?

Weiss: If a woman has a typical case of the flu and does not get viral

pneumonia, there aren't any major risks to the baby. There's very soft evidence

of

an increased miscarriage risk, but no risk of malformations or anything from

that virus. But if a woman's life is threatened by any condition, whether a car

accident or pneumonia, one of the body's responses is to save the woman's life

and reject the pregnancy. So severe flu could result in miscarriage or

premature delivery in the latter half of pregnancy.

Question: Is a pregnant woman more at risk of getting the flu?

: Not that I am aware of. I don't think pregnant women are more

susceptible.

Weiss: Flu doesn't seem to be any more catchy for pregnant women than for any

one else.

Question: Should a pregnant woman get the flu vaccine?

Weiss: The American College of Obstetrics and Gynecology recommends getting

the flu vaccine if you're going to be in your second or third trimester of

pregnancy during flu season. That's the 13th week. Now, if flu season runs from

October to April, once you conceive you never really are not in the second or

third trimester during flu season. So if flu vaccine is available, all pregnant

women should get it. The flu vaccine is not a live vaccine, so it is

considered completely safe during pregnancy. So for instance, if someone came in

six

weeks pregnant, she would be considered a candidate for vaccination because she

will still be pregnant during flu season. There is no time during pregnancy

when you can't give the flu vaccine. Many doctors prefer not to vaccinate early

in pregnancy due to the possible association between the flu vaccine and

miscarriage.

Question: Is a pregnant woman at any increased risk of flu vaccine side

effects?

Weiss: Most flu [vaccine] side effects are allergic reactions. So as a

pregnant woman has reduced immunity, her risk may actually be lower.

Question: What are the risks to the embryo/fetus if the mother gets the flu

vaccine?

Weiss: The killed vaccine flu shot is totally safe. FluMist, which is a live

vaccine, is not recommended for pregnant women.

Question: Should flu be treated differently in pregnant women?

Weiss: Tylenol or acetaminophen is the only pain reliever recommended during

pregnancy. Aspirin or naproxen or ibuprofen are not recommended for use during

pregnancy.

Question: What are the risks to the newborn or infant if a breastfeeding

woman gets the flu?

Clements: Due to the close contact between a mother and her baby, she is very

likely to give it to her child. The child won't get any sicker from nursing.

And nursing may help the child cut down on secondary bacterial infections. By

the time you realize you have the flu, you have already been contagious for a

couple of days. Obviously the youngest kids can get very sick, but you can't

tell in advance which five out of 100 kids will get severe flu. According to

the FDA, the flu virus cannot be transmitted through breast milk. A

breastfeeding mother can also get the flu vaccine without any increased risk to

herself or

her child.