Swine flu and pregnancy

Clinical characteristics of adult patients with influenza-like illness hospitalized in general ward during Influenza A H1N1 pandemic 2009/2010

OBJECTIVE

To investigate clinical and laboratory features of patients with Influenza A H1N1 virus infection hospitalized during 2009/2010 pandemic.

METHODS

Prospective observational study comparing clinical and laboratory characteristics of Influenza A H1N1 positive and negative patients with influenza-like illness (ILI).

RESULTS

From October 21, 2009 to February 14, 2010 196 ILI patients were admitted, of which 66 tested positive for Influenza A H1N1. The patients with H1N1 infection were younger (43 years vs. 65 years; P < 0.01), more patients were pregnant (P < 0.01), had allergies (P < 0.05) or, asthma (P < 0.01). H1N1 positive patients were more often febrile (91% vs. 72.9%; P < 0.01) and had a higher prevalence of headache (31.8% vs. 18.5%; P < 0.05). Lower values of C-reactive protein (88 pg/dl vs. 126 pg/dl; P < 0.01), procalcitonine (0.42 µg/l vs. 3.98 µg/l; P < 0.05), leukocyte count (7.4*10(9)/l vs. 11.7*10(9)/l; P < 0.01) and higher values of troponin (0.162 µ/l vs. 0.146 µg/l; P < 0.01) were found in H1N1 positive patients. More bacterial infections were found in H1N1 negative group (68.8% vs. 89.2%; P < 0.05).

CONCLUSIONS

In this study patients infected with Influenza A H1N1 differed from H1N1 negative ILI patients in several clinical and laboratory characteristics. The same was observed also by other investigators. The results of the study suggest some other specific features, such as a higher incidence of headache and higher values of troponin in Influenza A H1N1 infected patients.

Severe H1N1 virus in pregnancy requiring extracorporeal membrane oxygenation and lobectomy

Prompt diagnosis and treatment of H1N1 is crucial during pregnancy to prevent major morbidity and mortality as the virus poses an increased risk of severe illness in pregnant women. Currently, there is limited obstetric literature concerning pregnancy and the pandemic swine flu outbreak in the UK. Although there was a concerted effort to stockpile the HIN1 virus vaccinations, critical care adult extracorporeal membrane oxygenation is only available in one centre in the UK.