Maine CDC Director Issues Letter to Providers on H1N1 & Pregnant Women
Who Provide Health Care for Pregnant Women:
This letter has
important information. We need your
help to prevent serious illness and save lives among your patients. As you may know, pregnant women and infants
are being disproportionately affected by novel H1N1 influenza virus. Reports indicate that one-third of pregnant
women with novel H1N1 influenza virus are so ill, mostly with severe
respiratory distress, that they require hospitalization (Lancet, July 29,
2009). Deaths of otherwise healthy
pregnant women are also being reported.
Severe disease among pregnant women was reported from past pandemics,
such as the one in 1918.
We expect an
escalation of H1N1 infection this fall as well as the arrival of seasonal influenza. Therefore, your patients may more likely
encounter H1N1, and their ability to recover may be compromised if they also
encounter seasonal influenza.
One of the most important and immediate steps you can take is to register to
receive H1N1 vaccine from Maine CDC. As
a health care provider for pregnant women, we want to assure you and your
patients have early access to this vaccine.
Maine CDC will
be hosting a conference call for health care providers who care for pregnant
women on Thursday September 17th 12 noon – 1 pm. The call in number is: 1-800-914-3396 and the pass code is: 473623.
The purpose of the call will be to review the recommendations below and
to take your questions.
Recommendations for Clinicians Providing Health Care for Pregnant Women:
Recommend and offer H1N1 novel influenza vaccine for
pregnant women and their appropriate family members as soon as it arrives,
which we expect to be in mid-October.
receive H1N1 vaccine from the Maine CDC.
This requires you to fill out and submit a Provider Agreement for H1N1
Vaccine, which can be found at: http://www.maine.gov/dhhs/boh/maineflu/h1n1/provider-agreement-2009-2010.shtml. The H1N1 vaccine is free, will come with
some supplies, and you will be able to bill for vaccine administration. We expect to have some thimerosal-free H1N1
vaccine available for pregnant women.
Up to date CDC guidance on H1N1 influenza vaccine can be found at: http://www.cdc.gov/h1n1flu/vaccination.
- Recommend and offer seasonal influenza vaccine for pregnant women
and their appropriate family members now.
To order or find out information on obtaining seasonal influenza
vaccine contact the Maine CDC’s Immunization Program (287-3746) or the
Immunization Action Coalition’s website at http://www.preventinfluenza.org/ivats. Maine CDC has some thimerosal-free
seasonal influenza vaccine available for pregnant women and young
Educate and inform your patients.
Prepare your office for H1N1: http://www.maine.gov/tools/whatsnew/attach.php?id=76279&an=2
All pregnant women need to know the symptoms of
influenza and to report to a health care provider such symptoms
All pregnant women and their families need to know how
to prevent H1N1 (frequent hand washing, covering coughs and sneezes with tissue
or sleeve, and staying away from others who are sick).
If a friend or family member is ill, the pregnant woman
should arrange for someone else to care for those who are sick.
Post the enclosed posters. If you would like to receive additional copies, they can be
downloaded at http://www.maine.gov/dhhs/boh/Flu%20Posters.htm or
requested by emailing at email@example.com.
We ask that pregnant women who have suspected novel
H1N1 influenza A virus be tested for influenza.
Pregnant women who have symptoms consistent with
influenza illness should receive antiviral treatment as early as possible after
illness onset. Clinicians should not
wait for test results to initiate treatment.
Symptoms of influenza like illness are a fever (100
degrees or greater) and a sore throat or cough, in the absence of another cause
such as strep throat. If novel H1N1 is
prevalent in your area of the state (as it has been in southern Maine much of
the past 4 months), then these symptoms should be considered to be
Prophylaxis with an antiviral medication should be
considered for pregnant women who have been in contact with someone with novel
Keep updated with the latest treatment guidelines for
pregnant women: http://www.cdc.gov/h1n1flu/clinician_pregnant.htm.
Clinicians should call Maine CDC (1-800-821-5821) to
report pregnant women requiring hospitalization related to H1N1 or any outbreak
Clinicians can call Maine CDC 24 hours a day for
clinical consultation such as questions on testing or treatment: 1-800-821-5821.
US CDC H1N1 Clinicians’ Guidance for Pregnant Women http://www.cdc.gov/h1n1flu/clinician_pregnant.htm
CDC H1N1 Resources for Pregnant Women
CDC H1N1 Resources for Parents
the Maine CDC H1N1 Website: www.maineflu.gov
Check the Weekly H1N1 Updates:
weekly updates on H1N1 in Maine on Maine’s H1N1 website: www.maineflu.gov. You can subscribe to these updates via their RSS feed.
Sign Up to Receive Health Advisories:
Sign up to receive
urgent updates from Maine CDC’s Health Alert Network (HAN). The easiest
and quickest way is to sign up is through the HAN Alert RSS feed at www.mainepublichealth.gov
(midway down the center of the homepage).
Follow Maine CDC’s Updates and Other Information
Facebook (search for “Maine CDC”),
My Space (www.myspace.com/mainepublichealth),
Can’t Find an Answer, Consider Calling or
For health care providers: for clinical consultation, outbreak management guidance, and
reporting of an outbreak of H1N1 call Maine CDC’s toll free 24-hour phone line
for health care providers at: 1-800-821-5821.
Call-in Number for Questions:
NextTalk (deaf/hard of hearing) - (207)629-5751
Monday - Friday 9am - 5pm
Email Us Your
Questions at: Sue.Dowdy@maine.gov
Thank you very much for your
attention to protecting your patients from the severe effects of novel H1N1
influenza! Feel free to call or email
us if you have any questions or concerns, and join us on the September 17th
Dora Anne Mills, MD,
Director, Maine CDC/DHHS
State Health Officer
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