While most pregnant women with swine flu will only have mild symptoms, there is a higher risk of complications. If you are pregnant and think you may have swine flu, or have a sick child under one year old, call your GP – do not use the new National Pandemic Flu Service.
The National Pandemic Flu Service
A National Pandemic Flu Service has been launched. This will free up GPs so they can focus their efforts on helping those in at risk groups and patients with other illnesses.
If any of the below apply, contact your GP directly – do not use the National Pandemic Flu Service.
- you are pregnant
- you have a sick child under one year old
- your child has a serious underlying illness
- your child’s condition suddenly gets much worse
- your child’s condition is still getting worse after five days
Swine flu – prevention and treatment
Scotland, Wales and Northern Ireland
If you are in Scotland, Wales or Northern Ireland the advice is different.
Follow the ‘information around the UK’ link below.
I am pregnant. Am I at higher risk?
While most pregnant women with swine flu will only have mild symptoms like most other people, there is a higher risk of developing complications. If you are pregnant and think you may have swine flu, call your GP.
Pregnant women with swine flu may be given an antiviral drug called Relenza. Relenza is taken through an inhaler rather than a tablet. This means it builds up in your throat and lungs but not in your blood or placenta and should not affect your baby.
The Chief Medical Officer issued this advice on 20 July:
Some pregnant women who catch the swine flu virus will develop complications of the infection (including pneumonia) that could put their own and their baby’s health at risk. The risks are greatest in the second and third trimesters of pregnancy. It is too early in the pandemic of influenza to be able to quantify these risks for the individual but most pregnant women who catch the disease are likely to make an uncomplicated recovery.
Bearing these risks in mind, at present, mothers-to-be are not advised to curtail normal activities such as going to work, travelling on public transport, attending events and family gatherings.
They are advised to take the following steps to reduce their risk of infection and complications:
- observe good hand hygiene (frequent use of soap and water or sanitizer)
- wherever possible, avoid contact with someone who is known or suspected to have swine flu
- if they have flu-like symptoms, to make early contact with their General Practitioner who may advise treatment with antiviral drugs
Some mothers-to-be may wish to continue their day-to-day activities but exercise their choice now, on a highly precautionary basis, to avoid large densely-populated gatherings where they have little control over personal contact.
When the pandemic reaches its height (probably in the autumn) as many as 1 in 3 people may be affected. At that point, the Chief Medical Officer may make a more specific recommendation to mothers-to-be and others (such as those on chemotherapy) with weakened immune systems to avoid densely-populated gatherings.
There is no need for other family members (partners and children) to take special precautions but they should also practise good hygiene.
If you are pregnant, you are in one of the high risk groups for swine flu, so it is important you read this page carefully and follow the advice to protect yourself and your baby.
This page explains why pregnant women are at greater risk from swine flu, what those risks are, the special precautions you should take and the safety information for swine flu treatments.
Why pregnant women are more at risk
In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch swine flu, and if they do catch it, they are more likely to develop complications (see below).
However, it is important not to panic: your immune system still functions and the risk of complications is still very small. The majority of pregnant women will only suffer mild symptoms.
Symptoms and risks
If you are pregnant and you catch swine flu, the symptoms are expected to be similar to those of regular human seasonal flu. Typical symptoms are fever and a cough, and sometimes also tiredness, headache, aching muscles, runny nose, sore throat, nausea or diarrhoea.
Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications from flu.
Possible complications are pneumonia (an infection of the lungs), difficulty breathing and dehydration. In pregnant women, these are more likely to happen in the second and third trimester.
If a pregnant woman develops a complication of swine flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.
It is therefore important to be well prepared and to take precautions against swine flu.
Special precautions
If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.
Pregnant women should also follow the general advice outlined in the box, top right. Good hygiene is essential.
If a family member or other close contact has swine flu, your doctor may prescribe you antiviral medication (usually Relenza) as a preventative (prophylactic) measure.
If you think that you may have swine flu, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, you will be prescribed antiviral medication to take as soon as possible (see box, left).
Unless you have swine flu symptoms, carry on attending your antenatal appointments so you can monitor the progress of your pregnancy.
Swine flu treatment
Antivirals
If you are pregnant and diagnosed with swine flu, you will usually be given a course of the antiviral drug Relenza, which is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.
However, if your doctor or midwifery specialist thinks that a different medicine is needed (for instance, if you have unusually severe flu), you will be given Tamiflu instead.
An expert group reviewed the risk of antiviral treatment in pregnancy, which is extremely small – much smaller than the risk posed by the symptoms of swine flu.
Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or COPD. Other possible side effects include headaches, diarrhoea, nausea and vomiting.
Nausea is a known side effect of Tamiflu, in a small number of cases.
If you take an antiviral and have side effects, see your healthcare professional to check that you are ok. Then report your suspected drug reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) via their new online system.
Painkillers
You can also take paracetamol-base cold remedies to reduce fever and other symptoms. Paracetamol is safe to take in pregnancy.
However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).
Vaccine
It will be in the autumn before a swine flu vaccine becomes available. When it is available, there will be guidelines on which groups of people are a greater priority for vaccination.
You should take up the swine flu vaccine as soon as it is offered – it will not harm you or your unborn baby.
How do I tell if my child has swine flu?
As swine flu spreads, it is important to be able to recognise its symptoms and know what to do if you think that you or your family might have it.
One thing you can do right now is to make sure you have a thermometer to take your child’s temperature. If they have a temperature of 38° C or above and they have any two of the following symptoms, then you should call your GP straight away. The symptoms are:
- tiredness
- headache
- runny nose and sneezing
- sore throat
- shortness of breath
- loss of appetite
- vomiting and diarrhoea
- aching muscles, limb and joint pain
If your child is less than one year old and you think they might have swine flu, call your GP immediately.
If my child has swine flu, what should I do?
If your GP confirms that your child has swine flu, they should stay at home and you should treat their symptoms like any other cold or flu. Make sure they drink plenty of liquids, get lots of rest and take paracetamol to help control their temperature.
Your GP will tell you whether your child should also take antiviral drugs. Antivirals, such as Tamiflu, shorten the symptoms by about a day and can reduce the risk of complications.
However, they can also have side effects. If your child’s swine flu symptoms are mild, you may not wish to give them antivirals. Your GP can advise you on this.
How do I get antiviral drugs for my child?
If you decide that your child should take antivirals, your GP will give you an authorisation code. Then ask a ‘flu friend’ – a friend or relative who does not have swine flu – to take this code to one of your local antiviral collection points to pick up their antivirals. Your GP will tell you where these are.
Can I breastfeed if I’m taking antiviral drugs?
Yes. It is safe for to take Tamiflu or Relenza while you are breastfeeding your baby. If you or your baby are too ill to breastfeed use expressed milk if you can.
When will there be a vaccine?
Vaccines are complex and difficult to manufacture in large numbers. The NHS has signed contracts to get enough vaccine for the entire country as soon as it is available.
While the first batches of vaccine will start to arrive it will take several months to get enough vaccine for everyone. It will also take time to fully test the vaccine and to organise the vaccination of everyone in the country.
Will children be first in line for the vaccine?
Scientists and doctors are still testing the vaccine and studying the swine flu virus. When the vaccine becomes available we will prioritise those who need to get it first.
The papers say 65,000 people are going to die! Is that true?
No. The figure represents a planning assumption to ensure that the NHS can cope with the very worst case scenario. The 65,000 figure is the worst case scenario. It is not a prediction and the government does not expect that many deaths, but it is asking the NHS to prepare for it.
We are about to go on holiday, what should we do?
Wherever you go on holiday, you should always take the same sensible precautions that you do when at home. Know where you can get medical advice if you or your family feel unwell and make sure you have over-the-counter medication for coughs and sneezes.
If you are going on holiday in the UK then you can contact the local GP surgery or call the National Pandemic Flu Service helpline.
If you are travelling to Europe, make sure you have your free European Health Insurance Card (EHIC). This entitles you to any necessary medical treatment, including for swine flu, during a visit to another European Economic Area country. You can get an EHIC application form from the Post Office, by calling 0845 606 2030 or by applying online.
If you have swine flu, we recommend that you do not travel until after your symptoms have stopped.
Whenever you go abroad, always check the latest travel advice from the Foreign Office.
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Travel advice from the Foreign Office
