Tuesday, October 13, 2009

Flu Info for One and All

The following is from Kate Finn, MS, LM a wonderful homebirth midwife in Ithaca, NY. With her permission I am sharing this timely and important (!) information. The information is important for pregnant, non pregnant, ladies and for those not so ladylike as well.


Dear fecund, robust, and healthy pregnant ladies!

I've gathered some current information on the H1N1 flu for pregnant women and their families. See additional resource links below.

H1N1 is a new flu virus that began spreading in April 2009. People younger than age 60 do not have immunity against this virus, so it is expected to spread easily between people. The WHO and CDC have determined that the ease of spread means we are in the middle of a worldwide flu pandemic.

As of early September 2009, there are 500+ cases at Cornell University, with several hospitalizations, including one death. All current flu cases are considered to be H1N1, because seasonal flu is not currently circulating.

Flu risks in pregnancy:

If early pregnant with severe respiratory illness, increases risk of miscarriage or premature birth.

If later pregnant with severe respiratory illness, a smaller lung capacity can make respiratory symptoms worse.

This flu is more virulent for the young and adults for possible secondary bacterial infections and respiratory failure.

Six percent of confirmed fatal 2009 H1N1 flu cases last spring have been in pregnant women, while less than 1% of the general population is pregnant.

Flu during pregnancy increases risks in offspring of later developing schizophrenia.

Flu symptoms:

· Fever

· Muscle aches

· Tiredness

· Cough

· Sometimes, also:

· Sore throat

· Lack of appetite

· Runny nose

· Nausea or vomiting

· Diarrhea.

The flu is contagious for about 7 days, or if sicker longer, until 24 hours after clearing of fever.

Pregnant women, call your health care provider if:

If exposed to anyone with flu symptoms

You have any flu systems. Please call the first day so that you will have the option of getting the best effect if you choose to use Tamiflu.

Emergency warning signs that need urgent medical attention include:

· Fast breathing or trouble breathing

· Bluish or gray skin color

· Not able to drink enough fluids (8 cups/day)

· Severe or persistent vomiting

· Not waking up or not interacting

· In children, being so irritable that the child does not want to be held

· Flu-like symptoms improve, but then return with fever and worse cough

Primary flu prevention:

As with all health care, your healthy behaviors are the most important factors in maintaining your and your family's health. Here are some ideas:

1. Wash hands for 20 seconds with soap after contact with others and before eating.

2. There is some evidence that hand washing with Hibiclens 4% soap, available at pharmacies, maintains an anti-microbial film on the skin that kills flu virus up to 6 hours thereafter. Washing in the morning and at lunch can provide all-day protection for workers involved in public service.

3. Avoid using shared hand towels, use paper towels or air dry hands.

4. Avoid sharing water bottles or glasses, utensils or toothbrushes, and sharing food such as licks of an ice cream cone or finishing another person's leftovers.

5. Cover face with tissue when coughing or sneezing, toss tissue, then wash hands. 6. Obviously, keep tissues strategically throughout your environment or in your pocket.

7. If you don't have a tissue, sneeze or cough into your elbow.

8. Develop habits to avoid touching eyes, nose and mouth when you haven't recently washed your hands.

9. To maintain a healthy immune system, eat healthy balanced diet with fruits and vegetables, get good rest, and practice stress reduction.

10. Teach these behaviors to your children

11. Stay home or keep your children home if having flu symptoms until 24 hours after fever resolves without the influence of fever reducing medicines.

12. Medicines such as antiviral Tamiflu may reduce symptoms and make transmission to others less likely, especially if begun within 2 days of symptom onset; this is a category C medicine; medical advisors consider the benifits of this medicine to outweigh the risks for women who are pregnant or breastfeeding. However, some H1N1 flu strains have become resistant to antiviral medication.

13. Breastfeeding newborns can be protective. Wash hands before and after breastfeeding to lower transmission between mother and baby.

14. If having symptoms, use a face mask when going to see your health care provider, otherwise, stay home.

Natural care products:

Start natural care with the first onset of flu symptoms. Get prepared now.

Warning: Echinacea has not been more effective than a placebo in most randomized trials.

Warning: Zicam or zinc nose spray/gels have been associated with loss of smell.

Zinc works best when taken regularly (every two hours), using 10 milligrams of elemental zinc per lozenge for not longer than 3 days. Not recommended for children.

Vitamin C: keep it under 2000 mg per day. Try sipping Emergen-C throughout the day.

Vitamin D: good evidence 1000 IUs help boost immune system.

Garlic is known to boost immune system and prevent secondary infections such as ear infections, bronchitis and sinusitis: eat one raw clove twice daily when fighting colds and flu. Do not eat plain! It is yummy to crush fresh clove over most main course entres, on salads, in salsa, on potatoes with butter or olive oil, or spread on toast with butter or olive oil.

Elderberry cut the flu duration in half in one small randomized trial. My experience with elderberry has been wonderful, as when it seemed a cold or flu was starting, elderberry ended it before much could happen. I have used elderberry juice from fresh fruits, but a syrup can be made from dried fruits. Look for sources of juice, syrup or dried berries online. Wegman's carries elderberry tablets in the natural supplement section. Make some syrup now to have throughout the flu season:

Elderberry syrup recipe

1 cup dried berries

3 cups filtered water

1 1/2 cups honey

1 ounce fresh ginger root, grated

Juice of 1 lime

Combine berries, ginger and water in stainless steel or glass pot. Heat on medium until simmering. Continue to gently simmer uncovered for 45 minutes to an hour, or until reduced in volume by half. Remove from heat. Allow decoction to cool slightly. Strain well through cheesecloth, squeezing the juice from the berries. Measure liquid and combine with equal parts honey. Reheat to light boil. Add all the lime juice. Pour into glass jar, date, and store in the refrigerator for up to a year.

Take one tablespoon 2-3x/day daily during the cold and flu season. For children ages 2-5, use half the adult dose. Dose for ages 6-12 is two teaspoons twice daily. Nursing mothers can take one tablespoon 5 minutes before nursing to pass the benefits along to the baby.

About the H1N1 Vaccine:

Is a separate vaccine from regular seasonal flu vaccine. Both these two vaccines are recommended by the CDC for pregnant women.

H1N1 vaccine will likely be given in one dose.

The immune response gives protection against flu about 8-10 days after vaccination.

The seasonal flu vaccine is available now; the H1N1 vaccine will be available in mid-October.

Believed that getting vaccine in pregnancy will provide some protection for the baby in first 6 months of life.

Considered by CDC to be safe in pregnancy in any trimester.

This vaccine is produced in exactly the same manner as the seasonal flu vaccine, and is considered to have a similar safety profile. Serious adverse events with vaccine are so rare, cannot seen in the smaller clinical trials conducted.

Pregnant women must get vaccine injection from single dose vial to avoid the thymerisol preservative of multidose vial;

The flu mist spray is attenuated virus and can't be given to pregnant women, children under age 2, or adults with asthma.

This vaccine is made with egg culture, so if there is an egg allergy, this vaccine should not be given.

Risk groups recommended for H1N1 vaccination:

· Pregnant women

· Care providers of children less than 6 months of age (mothers, fathers, grandparents, daycare providers)

· Children over 6 months of age and young adults up to age 24

· Adults age 25 to 64 who have medical risks such as asthma, diabetes, lung disease, heart disease, etc

· Health care workers

More Information:

None of the following links are primary research. As such, the statements and studies can not be evaluated for weaknesses. The interpretations of the data occurs by doctors and public health policymakers. For example, one site says previous flu pandemics resulted in a case fatality rate of 27% for pregnant women. This figure would be artificially inflated if women stayed home and recovered from the flu without being counted. Still, it is seems clear that pregnancy does carry higher risk for serious flu complications including death.






I have tried to give out health information that can be helpful in deciding whether to choose vaccination or not. The primary prevention and natural care products can be used by anyone, whether or not you choose vaccination. Again, please let me know whether you choose vaccination for 1) seasonal flu and 2) H1N1 flu.

To good health!

Kate T. Finn, MS, LM

Ithaca NY

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