Health Alerts for Women

Protecting yourself against against the risks of

West Nile virus (WNV) and Equine Encephalitis (EEE)

mmIt is recommended that everyone (especially pregnant women) take precautions to prevent exposure to WNV and EEE-infected mosquitoes. The consequences of these infections in pregnancy are not well-defined, and at this time there is no good treatment for these infections. Prevention is especially important since both viruses have been detected in New Hampshire.

mmWe recommend the following simple steps:

• mlUse insect repellent that contains DEET on skin and clothes. When used according to the
• mlproduct label, DEET can be used safely by pregnant women without harming the fetus.

• mlWear clothing that protects from mosquito bites: long sleeves, pants, and a hat.

• mlAvoid being outside during the peak mosquito-feeding times, usually dawn and dusk.

• mlEliminate pools of stagnant water near your house; these are mosquito breeding areas.

mmFor more detailed information on WNV or EEE, visit this link at the NH Department of Health and Human Services website.

Q&A: Information for pregnant women about flu shots

Q: SHOULD I GET A FLU SHOT?

A: It is recommended that women who will be pregnant during influenza season be vaccinated. The complete recommendations from the CDC regarding vaccination are available at this link.

Q: SO WHAT? LOTS OF PEOPLE GET FLU AND IT DOESN’T HURT THE BABY.

A: Many people incorrectly use the term “flu” to refer to any virus that comes along, including colds and upset stomachs. However, “influenza” is a specific viral infection that causes high fever, muscle aches, breathing problems, and can last for a week or more. It is much more serious than having a common cold or upper respiratory infection, and some people with influenza need to be hospitalized. Each year, 200,000 Americans are hospitalized with influenza, and each year 36,000 Americans die from it. The chance of a woman in the third trimester of pregnancy needing to be hospitalized is the same as that of an elderly person or a person with a chronic medical condition.

Q: MY FRIEND GOT A FLU SHOT AND STILL GOT THE FLU. WHY?

A: There are different strains of influenza. In order to have sufficient vaccine available, production needs to start way in advance of the flu season, and each year’s vaccine is designed to prevent the strains which are predicted to be most prevalent that year. Sometimes, there are unpredicted strains of flu. Your friend may have had a different strain of flu. Or, your friend may have had a different virus and called it “the flu.” The vaccine is 70-90% effective in prevention of influenza; it is not 100%.

Q: ISN’T THERE A CHANCE OF THE SHOT GIVING ME THE FLU?

A:Absolutely not. There are two types of flu vaccine: one containing live virus, and another with NO live virus. Pregnant women and women who may become pregnant should get the one with NO live virus, which will NOT cause influenza. Up to 25% of people may have 1 or 2 days of aches or fever, and up to 65% note transient soreness at the injection site, but nobody gets influenza from the shot.

Q: ARE FLU SHOTS SAFE DURING PREGNANCY?

A: Flu shots have been recommended for pregnant women for years, and studies of thousands of pregnant women have revealed NO adverse effects on the baby. In fact, immunity is passed on to the baby and will last for up to 6 months after birth.

Q: HOW QUICKLY DOES THE SHOT WORK?

A: Immunity peaks 2 weeks after vaccination and lasts for up to 6 months.

Q: WHEN SHOULD I GET THE SHOT?

A: As soon as you plan to get pregnant, or at any time during pregnancy. Flu season runs from October to February or March. You should be immunized as early in the season as possible, but there is benefit in being vaccinated even through January or February.

Current recommendations on eating fish during pregnancy

mmMany types of fish products should be avoided altogether during pregnancy and while nursing. Certain types of seafood however are safe to eat.

mmDue to high potential mercury content, swordfish, shark, king mackerel and tilefish should be completely avoided. Some very-low mercury alternatives include shrimp, pickerel, whiting, salmon, tilapia, sardines, catfish, flounder and sole. We recommend no more than 12 ounces per week of these products, however. Because the data on mercury content in albacore (white) tuna is unclear, we recommend no more than 3 ounces per week. Or better: choose chunk light tuna, which has far less mercury than albacore.

mmAlso, lake fish should be avoided altogether, due to the risk of chemical/pesticide contamination. Raw or partially-cooked shellfish should be avoided due to the risk of bacterial contamination.

Vioxx, Bextra and Celebrex may interfere with conception

mmNew evidence also suggests that Cox-2 inhibitors such as Bextra, Celebrex and the now-withdrawn Vioxx may delay or otherwise interfere with ovulation. Therefore, those who are trying to conceive should avoid use of these drugs, except during menses.

Other NSAID pain relievers includes ibuprofen (Advil) and naproxen (Aleve). While there is no specific data yet that either of these two NSAIDs interfere with ovulation, it may be prudent to limit your use of them during your midcycle fertile period as well, especially if you have been having any difficulty conceiving.

mmWe recommend acetominophen (Tylenol) for pain relief for those who are trying to conceive.


			OBSTETRICS \| GYNECOLOGY \| FERTILITY \| COUNSELING SERVICES




	Protecting yourself against against the risks of West Nile virus (WNV) and Equine Encephalitis (EEE) mmIt is recommended that everyone (especially pregnant women) take precautions to prevent exposure to WNV and EEE-infected mosquitoes. The consequences of these infections in pregnancy are not well-defined, and at this time there is no good treatment for these infections. Prevention is especially important since both viruses have been detected in New Hampshire. mmWe recommend the following simple steps: • mlUse insect repellent that contains DEET on skin and clothes. When used according to the • mlproduct label, DEET can be used safely by pregnant women without harming the fetus. • mlWear clothing that protects from mosquito bites: long sleeves, pants, and a hat. • mlAvoid being outside during the peak mosquito-feeding times, usually dawn and dusk. • mlEliminate pools of stagnant water near your house; these are mosquito breeding areas. mmFor more detailed information on WNV or EEE, visit this link at the NH Department of Health and Human Services website. Q&A: Information for pregnant women about flu shots Q: SHOULD I GET A FLU SHOT? A: It is recommended that women who will be pregnant during influenza season be vaccinated. The complete recommendations from the CDC regarding vaccination are available at this link. Q: SO WHAT? LOTS OF PEOPLE GET FLU AND IT DOESN’T HURT THE BABY. A: Many people incorrectly use the term “flu” to refer to any virus that comes along, including colds and upset stomachs. However, “influenza” is a specific viral infection that causes high fever, muscle aches, breathing problems, and can last for a week or more. It is much more serious than having a common cold or upper respiratory infection, and some people with influenza need to be hospitalized. Each year, 200,000 Americans are hospitalized with influenza, and each year 36,000 Americans die from it. The chance of a woman in the third trimester of pregnancy needing to be hospitalized is the same as that of an elderly person or a person with a chronic medical condition. Q: MY FRIEND GOT A FLU SHOT AND STILL GOT THE FLU. WHY? A: There are different strains of influenza. In order to have sufficient vaccine available, production needs to start way in advance of the flu season, and each year’s vaccine is designed to prevent the strains which are predicted to be most prevalent that year. Sometimes, there are unpredicted strains of flu. Your friend may have had a different strain of flu. Or, your friend may have had a different virus and called it “the flu.” The vaccine is 70-90% effective in prevention of influenza; it is not 100%. Q: ISN’T THERE A CHANCE OF THE SHOT GIVING ME THE FLU? A:Absolutely not. There are two types of flu vaccine: one containing live virus, and another with NO live virus. Pregnant women and women who may become pregnant should get the one with NO live virus, which will NOT cause influenza. Up to 25% of people may have 1 or 2 days of aches or fever, and up to 65% note transient soreness at the injection site, but nobody gets influenza from the shot. Q: ARE FLU SHOTS SAFE DURING PREGNANCY? A: Flu shots have been recommended for pregnant women for years, and studies of thousands of pregnant women have revealed NO adverse effects on the baby. In fact, immunity is passed on to the baby and will last for up to 6 months after birth. Q: HOW QUICKLY DOES THE SHOT WORK? A: Immunity peaks 2 weeks after vaccination and lasts for up to 6 months. Q: WHEN SHOULD I GET THE SHOT? A: As soon as you plan to get pregnant, or at any time during pregnancy. Flu season runs from October to February or March. You should be immunized as early in the season as possible, but there is benefit in being vaccinated even through January or February. Current recommendations on eating fish during pregnancy mmMany types of fish products should be avoided altogether during pregnancy and while nursing. Certain types of seafood however are safe to eat. mmDue to high potential mercury content, swordfish, shark, king mackerel and tilefish should be completely avoided. Some very-low mercury alternatives include shrimp, pickerel, whiting, salmon, tilapia, sardines, catfish, flounder and sole. We recommend no more than 12 ounces per week of these products, however. Because the data on mercury content in albacore (white) tuna is unclear, we recommend no more than 3 ounces per week. Or better: choose chunk light tuna, which has far less mercury than albacore. mmAlso, lake fish should be avoided altogether, due to the risk of chemical/pesticide contamination. Raw or partially-cooked shellfish should be avoided due to the risk of bacterial contamination. Vioxx, Bextra and Celebrex may interfere with conception mmNew evidence also suggests that Cox-2 inhibitors such as Bextra, Celebrex and the now-withdrawn Vioxx may delay or otherwise interfere with ovulation. Therefore, those who are trying to conceive should avoid use of these drugs, except during menses. Other NSAID pain relievers includes ibuprofen (Advil) and naproxen (Aleve). While there is no specific data yet that either of these two NSAIDs interfere with ovulation, it may be prudent to limit your use of them during your midcycle fertile period as well, especially if you have been having any difficulty conceiving. mmWe recommend acetominophen (Tylenol) for pain relief for those who are trying to conceive.