Influenza Illness in Pregnant Indian Women: A Cross-Sectional Study

Abstract

Data about burden of influenza in pregnancy in India are scant. In order to assess the contribution of influenza to acute respiratory illness (ARI) in pregnancy, 266 north Indian pregnant females with febrile ARI were studied from December 2014 to May 2015. Twin nasopharyngeal/oropharyngeal swabs were obtained and tested for influenza viruses by RT-PCR. Fifty (18.8%) patients tested positive for influenza (A/H1N1pdm09 in 41, A/H3N2 in 8, and influenza B Yamagata in 1). Rigors, headache, and a family history of ARI were significantly more frequent in influenza positive patients. Oseltamivir and supportive therapy were administered to all confirmed cases. Nine influenza positive cases needed hospitalization for their respiratory illness, and 5 developed respiratory failure. Of these, 4 (3 in third trimester) succumbed to their illness. We conclude that influenza viruses are a cause of significant morbidity and mortality among pregnant females with ARI in north India. As such, appropriate preventive strategies of influenza vaccination and early initiation of antiviral therapy during illness are stressed.

Is TT Immunization in Pregnancy Enough in Indian settings?

“…Another neglected disease in pregnancy is Influenza, though it has been associated with considerable morbidity and mortality [6]. Historically in the 1918 pandemic, it was seen that the overall mortality among pregnant females who developed influenza-associated pneumonia was 27% and it exceeded 50% in the third trimester of pregnancy [33].…”

“…There are limited data describing the burden of influenza in pregnancy in India [6]. However, few sporadic studies can be found.…”

“…However, few sporadic studies can be found. A study done in north India in 2015 on 266 pregnant females was done to assess the contribution of influenza to acute respiratory illness (ARI) in pregnancy [6]. Two Twin Citation: Olsen Of these, 4 (3 in third trimester) succumbed to their illness.…”

“…However, India is still a long way from introducing influenza vaccine in the National Immunization Schedule as it is still grappling with the low immunization coverage of children. Also, appropriate preventive strategies of influenza vaccination and early initiation of antiviral therapy during illness should be stressed upon [6]. The various hurdles in introducing additional vaccines for expectant mothers are shortage of funds, lack of awareness about adult immunization, paucity of studies supporting such immunization in the Indian subcontinent and sole focus of government on childhood vaccination.…”

“…Pertussis also serves as a reservoir for disease transmission to unvaccinated/partially vaccinated young infants [5]. Just like pertussis, influenza is another neglected disease in pregnancy, though it has been associated with considerable morbidity and mortality [6].…”