H1N1 Flu (Swine Flu)

Like all types of flu, the H1N1 flu (also known as swine flu) is caused by a virus. In the spring of 2009, many people in Mexico got sick wth H1N1 flu. It has now spread to several countries. A vaccine for H1N1 flu has been developed and is being distributed. 
Flu viruses spread mainly when people who have the disease cough or sneeze. Sometimes people become infected when they touch an infected surface (like a phone receiver) and then touch their mouths or noses.

A person cannot get H1N1 flu by eating or preparing pork.

Symptoms of H1N1 Flu

The symptoms of H1N1 flu in people are similar to the symptoms of regular seasonal flu. They include:

• Fever (however, some people with flu may not have a fever)
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue
• Diarrhea
• Vomiting

Often symptoms come on very quickly. If you or a member of your family has flu-like symptoms, contact your health care provider, especially if the symptoms get worse.

Pregnant Women and H1N1

Pregnant women are at increased risk for getting H1N1 flu. There are many reasons why women are more likely to get the flu during pregnancy.
Lower Immune System
The immune system is the natural defense system that helps protect you from illnesses and diseases. During pregnancy, your immune system isn’t as quick to respond as it was before pregnancy. Part of this is because your body is carrying something that it considers foreign and isn’t normally part of you (in this case, your baby). Usually when this happens, the immune system wants to protect you and will do its best to fight off this foreign object. But, since your body doesn’t want to reject your baby, it naturally lowers the immune system’s ability to defend and respond. But, a lowered immune system means you’re more defenseless against illnesses like the flu.

Time Spent Around Small Children
Pregnant women often spend much time around little children. And since kids spend so much time with other kids, often get close to one another and are always putting things in their mouths, this makes them perfect carriers of germs and bacteria. These germs can eventually make their way to you. And remember, your immune system during pregnancy isn’t as tough as it is when you’re not pregnant.

Body Working Overtime
During pregnancy, especially in your second and third trimesters, you need more oxygen than before because you’re supplying it to both you and baby. Your growing belly puts more pressure on your lungs, making them work harder in a smaller space. You may even find yourself feeling some shortness of breath at times. Your heart is working very hard, too! It’s busy supplying blood to you and baby. All of this means your body is stressed during pregnancy. This stress on your body can increase your risk of getting an illness like the flu.

For many pregnant women, the illness will be mild. But for some, the H1N1 flu will progress rapidly, and symptoms (such as pneumonia and dehydration) can be serious and even fatal. Some women who have the flu may go into preterm labor. That’s why pregnant women should get the vaccine to protect against the H1N1 flu.

If you are pregnant, pay close attention to your body and how you feel. If you have flu-like symptoms:

Contact your health care provider right away so that flu medications can be started immediately. The U.S. Centers for Disease Control and Prevention (CDC) recommends that pregnant women who appear to have the H1N1 flu take an antiviral drug. You must have a prescription from your health provider to get this medication.  These medicines work best if they are taken as soon as you have symptoms of the flu.  That’s why it’s important that you call your doctor as soon as you notice flu-like symptoms.
Treat a high fever right away. During pregnancy, high fever may be especially dangerous to the baby. Acetaminophen appears to be the best way to treat fever during pregnancy.
Stay home.
Limit contact with other people.
Drink plenty of fluids, but avoid drinks that have a lot of sugar.
Have someone check on you regularly.
If you are pregnant, avoid caring for anyone who has or may have the H1N1 flu if at all possible. The CDC also recommends that pregnant women who have close contact with a person who has or may have the H1N1 flu take an antiviral drug.

Infants, Children and H1N1 Flu

When children under 1 year of age get the flu, they are usually at high risk for complications, including serious conditions such as pneumonia.

Because of the possible risk of complications, infants with the H1N1 flu may benefit from an antiviral drug. If your child becomes ill, talk about this option with your baby’s health care provider.

Breastfeeding Women and H1N1 Flu

If you are breastfeeding and have signs of the H1N1 flu, talk to your health care provider. If your provider agrees, you can continue breastfeeding while you are ill, even if you are taking an antiviral drug. Mother's milk is made to fight disease. It can help your baby avoid the flu.

To reduce the risk to your baby, wash your hands often. You may also want to wear a face mask.

According to medical scientists, babies are unlikely to get the H1N1 flu from breastmilk. 

If you feel too ill to breastfeed, you may pump your milk if you feel up to it.

H1N1 Flu Vaccine

Pregnant women should get the vaccine to protect against the H1N1 flu. Check with your health care provider about the vaccine. Expecting moms should also get the vaccine to protect against seasonal flu.

There are two kinds of H1N1 vaccine:

The H1N1 flu “shot” (injected directly into the muscle, like many other vaccines)
The H1N1 nasal spray flu vaccine
While most adults and children can get the nasal spray vaccine, pregnant women should get the H1N1 flu shot.

Some H1N1 flu vaccines have a preservative called thimerosal. Although some people have suggested a link between thimerosal and autism, medical experts from the Institutes of Medicine (IOM) have thoroughly researched the issue and concluded that thimerosal-containing vaccines are NOT associated with autism. However, if you’re still concerned, a thimeresol-free version of the H1N1 vaccine will be available.

Getting the H1N1 flu vaccine during pregnancy will help protect mom and baby from the disease, which can be very serious for some pregnant women. Also, by getting the vaccine during pregnancy, a pregnant mom will be able to pass her immunity to her baby so that when he’s born, he’s less likely to get the H1N1flu in his first months of life.

Some pregnant moms might be concerned about vaccines potentially causing harm to themselves or their babies. The process for making the  H1N1 vaccine is the same as the one for making the seasonal flu vaccine. This process has been used for many years and has been thoroughly tested. The H1N1 flu is simply a new virus strain. Millions of Americans get the seasonal flu vaccine each year without any problems. To be doubly careful, the National Institutes of Health (NIH) and the vaccine makers have conducted more rigorous tests on the H1N1 vaccine than they do on other flu vaccines. The clinical trials conducted have shown that the new H1N1 vaccine is both safe and effective for pregnant women and babies.

Other groups of people who should be the first to receive the H1N1 vaccine are:

People who live with or care for children younger than 6 months old
Persons between the ages of 6 months through 24 years of age (children from the age of 6 months up to 9 years need two doses of the vaccine, given about a month apart)
Health care and emergency workers
People aged 25 through 64 who have chronic health problems or weak immune systems (examples of chronic health problems are asthma, diabetes, lupus and obesity)
Other Tips to Avoid H1N1 Flu
In addition to getting the H1N1 flu vaccine, here are some other things you and your family can do to help protect yourself and your family against the H1N1 flu and the usual seasonal influenza that we see during winter months.

Wash hands often with soap and warm water. Wash for 15 to 20 seconds every time. Alcohol-based hand cleansers also work well. Handwashing is very important for babies and small children because they put their hands in their mouths a lot.
Avoid people who are ill.
Stay home from work or school if you are sick.
Use a tissue when you cough, sneeze or spit. Cover your mouth. Put the used tissue in a covered trash bin.
Keep hands away from face. Avoid touching eyes, nose or mouth.
Clean shared objects (phones, remotes, keyboards, door handles) more often than usual. This can help stop the spread of germs.
Don’t share personal items such as forks, spoons, toothbrushes, towels, pacifiers and toys that a baby may put in his mouth.
Thoroughly wash with soap and warm water anything that has been in a baby's mouth.
Put a pacifier, including the handle, only in one baby's mouth. Do not put it in anyone else's mouth.
In case you or someone in your family gets the flu, stock up on healthy liquids, acetaminophen, and foods that will keep, like frozen foods or canned goods.

Emergency Warning Signs

Sometimes, the H1N1 flu worsens and the person needs immediate medical care. If you or anyone in your family has the following symptoms, contact your health provider right away:

For Infants and Children

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or interacting
• Being so irritable that the child doesn’t want to be held
• Fever with a rash
• Flu-like symptoms improve, but then come back with fever and worse cough

For Adults

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or belly
• Sudden dizziness
• Confusion
• Severe vomiting
• Vomiting that goes on and on 
• High fever that is not responding to acetaminophen
  Remember: H1N1 flu is a new illness and issues around it may change over time. Talk to your health provider to get the most up to date information or visit the CDC Web site. See our joint statement for pregnant women about influenza.