Influenza A H1N1 : Antiviral agents and vaccine.

The pandemic A H1N1 flu : mothers-to-be take care!
The pandemic A H1N1 flu, appeared in central Americas during Spring 2009, is spreading over Europe and Switzerland since Fall 2009. In healthy individuals, the virus most often causes an infection similar to seasonal flu. However, it has been shown to occasionally induce serious complications in 2nd or 3rd trimester pregnant women. During the follow up of the pandemic in Australia and New Zealand, pregnant women were clearly over-represented among the persons necessitating hospital care or ICU admission.  

Such observations have prompted the authorities to include pregnancy among the risk factors for complicated A H1N1 viral infection. Childbearing women should protect themselves against contagion and be offered vaccination. In case of flu symptoms, they should seek for medical advice to decide upon antiviral medicine prescription.

The recommendations of Swiss health authorities are summarized on the Website consecrated to the pandemic flu. The Website of the Federal Office for Public Health (only available in German, French or Italian) also presents useful information for both the public at large and the health professionals.

STIS implicated in vaccine safety assessment
For flu vaccines and antiviral drugs recommended in pregnant women, the data collected to date have not revealed concerns regarding reproductive safety. However, the amount of clinical observations available are still scarce. Therefore, the safety of those agents in pregnant women cannot be considered as fully established yet, even though there exist good clues for a favorable benefit/risk ratio, considering the aknowledged risk of complicated flu in this group.

Thus, there is a clear public health interest to extend the collection of clinical observations in pregnant women receiving those therapeutic agents. Therefore, Swissmedic has requested that the Swiss Teratogen Information Service (STIS) collect into two prospective registries the data from all pregnancy exposures to antiviral agents (TAMIFLU/RELENZA) and to the CELTURA flu vaccine, respectively. The recording of FOCETRIA vaccine exposures is already underway in other countries, which explains why the Swiss registry is limited to CELTURA. The aim of this prospective survey is to confirm on a large basis of clinical observations the safety and tolerability of those therapeutic agents. For further details, please read the corresponding pages on this Website.

We thus encourage all mothers-to-be to accept their inclusion in these registries, if they are to receive antiviral drugs or the CELTURA jab. We thank in advance their practitioners for filling in completely and sending us the opposite downloadable form.

Notification form