In Dealing with Influenza Infection in Pregnant Women

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In Dealing with Influenza Infection in Pregnant Women

Journal Title: Interventions in Gynaecology and Women’s Healthcare - Year 2018, Vol 2, Issue 2

Abstract

Influenza (Flu) is a very common infection in general population. It is generally mild and self- recovered infection, however, very few people know the fact that it has a sophisticated assortment in the viral structure (antigenic shift) and its course of the disease itself can result in a tremendously harmful outcome. There were so far 4 pandemic attacks worldwide. Spain in 1918 (unknown strain but suggestive of avian-like H1N1), Asian flu in 1957 by H2 N2, Hong Kong in 1968 and Mexico in 2009. After all the pandemic attacks, health personnel become more aware of its lethal complications as well as its after-maths. Normally, it occurs as a seasonal flu and as an endemic entity but it gets upgraded into epidemic then pandemic. For a virus, it is a single-stranded, enveloped RNA virus from Orthomyxoviridae family. Its incubation period is 2- 5 days and the transmission is mainly air-borne i.e. droplet inhalation or direct transmission or contact through hands and fomites. There are 4 types of virus (A, B, C and D). The commonest and the most virulent pathogenic group is group A which has well-known subtypes like H1 N1 (Swine flu or 2009 Pandemic flu), H5 N1 (2004 Avian flu), H3 N 2 (1968 Hong Kong flu) and others. There are no other subtypes in group B, C and D. The subtypes are classified based on antibody responses to glycol proteins such as hemagglutinin (HA) and neuraminidase (NA) on the surface of the virus [1]. The clinical presentations are generally headache, fever, dry cough, sneezing, running nose, malaise, muscle ache and pain, sore throat, but one third may be asymptomatic. The cough may persist for about two weeks after other symptoms subside. The symptoms can be overlapped with those caused by other viral upper respiratory tract infections (URIs) including human para influenza virus, adenovirus, entero virus and paramyxo viruses which will cause influenza-like illness (ILI) [2]. The harmful effect is more pronounced in pregnant women, children under 5 years, elderly people, immune-compromised patients, general debility and the patients with underlying respiratory illness especially asthma. The reason for the pregnant women being prone to severe influenza infection is due to physiological changes like increased heart rate, stroke volume and O2 consumption, decreased lung capacity and a shift away from cell- mediated immunity towards humoral immunity [3]. During the 2009 pandemic flu, 10% of pregnant women were among those admitted to the hospital in Florida, USA [4]. Even in seasonal outbreak, pregnant women are found to be affected more than non-pregnant adult women in terms of morbidities like an increase in hospital admission, increased admission to ICU and long-term hospital stays. Diagnostic test recommended is reverse transcription polymerase chain reaction (RT-PCR) test and viral culture [5]. A rapid influenza antigen test (RIATs) is another onestop useful test in our clinical practice and its use is agreed by CDC although the sensitivity is 40-69% [6].The specimens collectable are from nasal swabs, nasopharyngeal swabs, throat swabs, endotracheal tube aspirates and broncho pulmonary secretions from lavage.

Authors and Affiliations

Myat San Yi, MiMi Khaing, Soe Lwin

Keywords

Influenza infection in pregnancy Journal of Gynaecology Journal of Obstetrics and Gynaecology Obstetrics & Gynecology Journals Journal of Women's Health Care Journal of Gynecology and Women's Health Gynecology and Women's Health Journal of Women's Health Care Gynecology Journals lupine publishers journals

EP ID EP573218
DOI 10.32474/IGWHC.2018.02.000132
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