Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
As one of the two MedPage Today writers on full-time H1N1 duty since the beginning of the outbreak in April, I feel like I know the issues well enough to help clear up misconceptions when they come up in conversation.
The other day, just such a situation presented itself. An acquaintance of mine, who is pregnant, said she was very concerned about H1N1 because “pregnant women can’t fight it off.”
Although pregnant women have a tougher time fighting off infection from H1N1 and other pathogens, it’s certainly not a lost cause. But I let that one go.
This acquaintance’s fear was heightened, however, by something she had heard — that pregnant women who come down with H1N1 flu can’t be treated the same way as non-pregnant people because the drugs used to battle the virus will kill the baby. Not might kill the baby. Will kill the baby.
I was shocked when I heard this because presumably she was talking about antivirals, for which pregnancy is not a contraindication.
I was also surprised because this is not a myth surrounding the H1N1 pandemic that I’d heard before.
For the record, oseltamivir (Tamiflu) and zanamivir (Relenza) are “Pregnancy Category C” drugs, which means there haven’t been any clinical studies evaluating the safety of these medications for pregnant women.
But they’ve been used for seasonal flu and according to the CDC, “the available risk-benefit data indicate pregnant women with suspected or confirmed influenza should receive prompt antiviral therapy.”
For treatment of pregnant women, the CDC recommends oseltamivir as the drug of choice because of its systemic activity.
The agency is less clear regarding chemoprophylaxis: “Zanamivir may be preferable because of its limited systemic absorption; however, respiratory complications that may be associated with zanamivir because of its inhaled route of administration need to be considered, especially in women at risk for respiratory problems.”
I explained to my acquaintance that the CDC recommends antiviral treatment for pregnant women and that there was no evidence that the drugs were killing fetuses.
I hope, in the event that she does develop flu-like symptoms, that she won’t hesitate to seek treatment.
The exchange made me wonder, though: What other misconceptions about H1N1 and the vaccine are floating around out there?
Todd Neale is a staff writer at MedPage Today and blogs at In Other Words, the MedPage Today staff blog.
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