Flu Surges Among Pregnant Women

http://msnbc.msn.com/Default.aspx?id=3678186&p1=0

Flu surges among pregnant women
Dallas hospital reports sharp rise in cases
MSNBC staff and news service reports
Updated: 7:59 p.m. ET Dec. 10, 2003
DALLAS - Flu cases among young pregnant women surged at a large public
hospital, calling attention to yet another group at serious risk of the flu.
About 80 expectant mothers have been diagnosed with the flu since early
October, and more than 60 were treated for a time in the intensive care unit
at Parkland Health and Hospital System, said Dr. Jeanne Sheffield, a
maternal and fetal medicine specialist.



Pregnancy weakens a woman's immune system, making her more vulnerable to the
virus. Only two of the women had the flu shot, and they had it just before
they became ill, so they were not protected.

But Sheffield said it is rare to see so many pregnant women get sick. Most
were in their teens and early 20s; all recovered and are out of the
hospital.

"Maybe we may have admitted five or 10 a year in the past," Sheffield said.
"This is much different than normal."

It isn't clear why Parkland had so many flu cases among pregnant women. Some
health officials speculate that it's because Parkland - with 15,000 births
annually among the leading hospitals for deliveries - is a large public
hospital that treats many uninsured people. Its patients are less likely to
see a doctor regularly or early in an illness, Sheffield said.

A Texas Department of Health survey found no other serious outbreaks among
pregnant women in the state, and the Centers for Disease Control and
Prevention has not heard of any similar outbreaks in the nation.

Sheffield believes Parkland also is being more aggressive about testing for
the flu than other hospitals. Testing was done on all pregnant women who
showed flu symptoms after one sick woman with an unusually high heart rate
was diagnosed with it in October.

"Suddenly all of us were very aware that influenza was around, and it was
affecting our pregnant women," she said. "We jumped on it very, very
quickly."
Among the states with major flu outbreaks, Texas was the first where the
virus was widespread. That may explain why Dallas is the first to report
such a high number of ill pregnant women, said Dr. Tim Uyeki, a CDC
epidemiologist.

"Any type of infection can lead to pre-term labor," Sheffield said, adding
that the flu can progress to more dangerous infections such as pneumonia or
meningitis.

While flu shots are encouraged for everyone, women in their second and third
trimesters are among those at high risk, along with women at any stage of
pregnancy who are HIV-positive.
Parkland began a vaccination campaign among pregnant women when doctors
noticed the upswing in cases, Sheffield said, and free shots are offered to
all pregnant women treated at the hospital or any of its community clinics.

The number of flu cases began to taper off last week, the doctor said.

Search for more vaccine
Meanwhile, government officials said Tuesday they are searching for
alternative supplies of influenza vaccine and monitoring whether shortages
are putting patients in danger.

"We know that some areas of the country are particularly hard hit with
influenza and it has been a difficult and frightening thing for many people,
particularly in the context of reports of vaccine shortages," Dr. Julie
Gerberding, director of the CDC, told a news conference.

For example, supplies of flu shots at Georgia's public health clinics are
running low, though the vaccine still may be available with private
providers, state health officials said.

"We are starting to run out," said Richard Quartarone, spokesman for the
Georgia Division of Public Health. "What we have we have. Some districts
have a little more than others."


Health districts in Cobb and DeKalb counties have started to reserve
remaining supplies for the elderly, infants between 6 months and 23 months
and those with compromised immune systems.

CDC's Gerberding said the two companies that make the flu vaccine thought
they made enough, but did not anticipate that the flu season would start
earlier and include a more severe strain than seen last year.

"We have a gap between what we wish we have and what we have," Gerberding
said. "We are trying to get vaccine to the people who who need it most."

Drug maker Chiron Corp. said Tuesday it is working with the U.S. government
to help boost flu vaccine supplies for this year after raising production of
its own vaccine by about 50 percent versus last season. The company also
said it was assessing the possibility of using extra production material to
supply an additional 400,000 doses of its vaccine.

The vaccine was formulated last year and includes a mix of the three most
common strains at the end of the season in February. The Fujian strain now
causing severe disease was around, but manufacturers had trouble getting it
into the vaccine mix, Gerberding said.

"Viruses are finicky. They don't always grow well in eggs," she said. The
vaccine is made using chicken eggs.

So the manufacturers decided that they would leave the Fujian strain out of
the mix so as not to jeopardize overall production, she said.

Increased demand for vaccine


Last year the vaccine manufacturers -- Aventis Pasteur and Chiron -- had to
throw away 12 million doses because so few people bothered to get flu shots.
Gerberding said 185 million Americans fall under the guidelines for getting
the flu vaccine, but only between 70 million and 75 million usually are
vaccinated.



"For the last five years we have thrown a lot of flu vaccine away," she
said. Last year the two companies made 95 million doses, but because of the
12 million doses left unused, they reduced that number this year to 83
million doses.

Gerberding noted, however, that the latest flu season started early and the
predominant strain is the H3N2 Fujian strain, known to cause a more severe
disease. These factors pushed up demand for the vaccine.

"So the trick here is what we can do as federal agency to assure the
manufacturers will make more doses than we need on average," Gerberding
said.

She said Health and Human Services Secretary Tommy Thompson had asked the
CDC to make recommendations, which may involve the government paying the
manufacturers to make more vaccine.

The CDC meanwhile is checking who has the vaccine and who does not. The
entire production had been spoken for, but Gerberding said it would take
time to determine where all the doses went.

The CDC said it would closely watch flu complications among children, who
have swamped hospitals in some states and surprised doctors with the
severity of their illnesses.


A new concern is the rise of a common drug-resistant staph infection that is
undermining efforts to treat children with the flu, an official with the CDC
said Monday.

Dr. Tim Uyeki, epidemiologist with the influenza branch of CDC, said that
some children have died from the staph infections -- a phenomenon the CDC
has not seen before.

Flu and its complications are the sixth leading cause of death nationally
among children age 4 and younger, according to the CDC.

"Nan" wrote
I have been ill this winter, but not as bad as I've been reading, nor
as bad as many people I know.
*knock wood*

Nan

I am just getting over a cold, and typically when I got a cold before I was
pregnant it would drag on and on, and the congestion would linger forever.
This time I was sick for a few days, only had a sore throat for a couple,
and am already feeling much better sooner. I am not eating as well or as
much as I should and have not been taking my vitamin for a month or two....I
am going back on it though (stopped it due to vomiting).

"Nan" wrote in message
...

I always here this, but it must be a ymmv thing, as I always stay
healthier during pregnancy. I figure I'm eating better and taking
vitamins, which must help.
I have been ill this winter, but not as bad as I've been reading, nor
as bad as many people I know.
*knock wood*


I totally agree with you. I had the flu last week. I had a fever of 102-103
for 3 days but it wasn't nearly as bad as in past years. Even the bone and
muscle pains from the fever weren't as bad as usual.

Love
--
Nicky

EDD March 26, '04. It's a girl!

"Carol Ann" wrote:
http://msnbc.msn.com/Default.aspx?id=3678186&p1=0

Flu surges among pregnant women
Dallas hospital reports sharp rise in cases
MSNBC staff and news service reports
Updated: 7:59 p.m. ET Dec. 10, 2003
DALLAS - Flu cases among young pregnant women surged at a large public
hospital, calling attention to yet another group at serious risk of the flu.
About 80 expectant mothers have been diagnosed with the flu since early
October, and more than 60 were treated for a time in the intensive care unit
at Parkland Health and Hospital System, said Dr. Jeanne Sheffield, a
maternal and fetal medicine specialist.

A whole lot of pregnant women get flu and one hospital blames it on
the patients' being pregnant?! Sheesh, that's a good reason to avoid
ever stepping foot inside that hospital. Given that there is not a
comparable trend nationwide, the blame should perhaps fall instead on
the hospital. Bad ventilation in the prenatal clinic waiting room? A
contagious nurse or desk staff person who was allowed to work despite
being sick?

(pologirl) wrote in message . com...
"Carol Ann" wrote:
http://msnbc.msn.com/Default.aspx?id=3678186&p1=0

Flu surges among pregnant women
Dallas hospital reports sharp rise in cases
MSNBC staff and news service reports
Updated: 7:59 p.m. ET Dec. 10, 2003
DALLAS - Flu cases among young pregnant women surged at a large public
hospital, calling attention to yet another group at serious risk of the flu.
About 80 expectant mothers have been diagnosed with the flu since early
October, and more than 60 were treated for a time in the intensive care unit
at Parkland Health and Hospital System, said Dr. Jeanne Sheffield, a
maternal and fetal medicine specialist.

A whole lot of pregnant women get flu and one hospital blames it on
the patients' being pregnant?! Sheesh, that's a good reason to avoid
ever stepping foot inside that hospital. Given that there is not a
comparable trend nationwide, the blame should perhaps fall instead on
the hospital. Bad ventilation in the prenatal clinic waiting room? A
contagious nurse or desk staff person who was allowed to work despite
being sick?

I think you might be a little unfair here. They likely didn't catch it
at the hospital. Most people get their prenatal care at places other
than hospitals. Likely they went to the hospital BECAUSE they had the
flu.

And, I think they are probably right - pregnancy DOES suppress the
immune system, and pregnant women ARE at higher risk for catching
things.

As for avoiding hospitals... That's what I did. Had my kid at
home!

Cathy Weeks
Mommy to Kivi Alexis 12/01