Rheumatoid Arthritis and the Flu:

The CDC has an important message for people with immune systems compromised by diseases such as rheumatoid arthritis . You are at risk for both seasonal and 2009 H1N1 flu complications and should be vaccinated as soon as the vaccine becomes available in your community. To find a vaccination location near you, search the CDC website. The CDC suggested that patients with inflammatory rheumatic disease receive the 2009 H1N1 vaccine and the seasonal flu vaccine.

Young people and the Flu:

The CDC held the first of their two weekly H1N1 briefings today and said that young people continue to be hit especially hard by the 2009 H1N1 virus. More than half of the hospitalizations from 2009 H1N1 flu reported by 27 states from September 1^st and October 10^th were people age 24 and younger. About 23 percent of the deaths reported from 28 states during this period were in this age group.
In addition, about 90 percent of the hospitalizations and deaths from the 2009 H1N1 flu are in people age 64 and younger. With seasonal flu, we usually see the reverse – 60 percent of the hospitalizations and 90 percent of deaths from seasonal flu are in people age 65 and older.

Yesterday, the CDC circulated an alert reminding health care providers about early treatment of flu for patients at increased risk of complications. The CDC urges health care providers to start antiviral treatment as soon as possible when flu is suspected in these patients at risk and not wait for laboratory confirmation.

To help get antivirals to states, 300,000 additional doses of liquid Tamiflu for children were recently distributed through the Strategic National Stockpile. In addition, many pharmacies can create doses appropriate for children from existing supplies through a process called “compounding.” Many drug stores across the country, including Walgreens and Wal-Mart, are compounding antivirals locally to meet the needs of young children.

Pregnant Women and the Flu:

Five things you need to know

Pregnant women, even ones who are healthy, can have medical complications from the seasonal and H1N1 (Swine) flu. If you are pregnant, use the following 5 tips to prepare for the upcoming flu season.

1. Get vaccinated. If you are pregnant, you should get both the seasonal flu vaccine and H1N1 (Swine) flu vaccine as soon as possible. Pregnant women are among the priority groups to receive the H1N1 (Swine) flu vaccine. Use our Flu Shot Locator to get vaccinated where you live.

Note that pregnant women should not be given the nasal-spray flu vaccine LAIV (FluMist®)

2. Pay attention to your body. If you are pregnant, you should pay close attention to your body and how you are feeling. If you get sick with flu-like symptoms:

pregnant woman with holding glass of water

Stay home, limit contact with others, and call your doctor. Your doctor will decide if testing or treatment is needed. Tests may include a nasal swab which is best to do within the first 4-5 days of getting sick.
If you are alone, have someone check in with you often if you are feeling ill. This is always a good idea.
If you have close contact with someone who has H1N1 (Swine) flu or is being treated for exposure to H1N1 (Swine) flu, contact your doctor to discuss whether you need treatment to reduce your chances of getting the flu.

3. If you are diagnosed with the flu, get treatment:

Treat any fever right away. Acetaminophen (Tylenol®) is the best treatment of fever in pregnancy.

Drink plenty of fluids to replace those you lose when you are sick.

Your doctor will decide if you need antiviral drugs such as Oseltamivir (Tamiflu®) or Zanamivir (Relenza®). These medicines can make you feel better faster and make your symptoms milder. Because of its systemic activity, oseltamivir (Tamiflu®) is preferred for treatment of pregnant women.
Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) work best when started soon after symptoms begin (within two [2] days), but they may also be given to very sick or high risk people (like pregnant women) even after 48 hours. Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) are taken for 10 days.

There is little information about the effect of antiviral drugs in pregnant women or their babies, but no serious side effects have been reported. If you do think you have had a side effect to antiviral drugs, call your doctor right away.

4. Seek emergency medical care right away if you have:

doctor and pregnant patient in doctor's office

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Decreased or no movement of your baby
A high fever not responding to Tylenol®

5. Keep Breastfeeding

A mother’s milk is made to fight diseases in her baby. This is highly important in young babies whose immune system is still growing. Do not stop breastfeeding if you are ill. Mothers who are breastfeeding can continue to nurse their babies while being treated for the flu.
Breastfeed early and often. Limit formula feeds if you can. This will help protect your baby from infection.
If you do get the flu, be careful not to cough or sneeze in the baby’s face and wash your hands often with soap and water. Your doctor might ask you to wear a mask to keep from spreading this new virus to your baby. If you are too sick to breastfeed, pump and have someone give the expressed milk to your baby.