Advice to pregnant women
The public health minister Gillian Merron has been in the job just a few weeks, but she might have been expected to have been able to repeat the official guidance to pregnant women on swine flu and crowds.
You can find it in the NHS Choices website. Regarding , it says:
"If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible. Pregnant women should also follow the general hygiene advice."
The key word, which I have put in bold, is "unnecessary". More on that in a moment.
But now to the minister. On the 91Èȱ¬ News channel Sunday lunchtime, she was asked whether pregnant women should avoid crowds, and had this to say:
"Perhaps I can clarify. We are not advising pregnant women not to travel or not to go into crowds. It's advice if people have swine flu, because as all your viewers will know, the advice, the strong advice if you have swine flu, is to stay at home."
Clarity was perhaps not helped by the Department of Health's decision to "re-state" its advice to pregnant women today - which meant moving it to a more prominent position on .
But this does not contain specific advice on travel and crowds. It never did. So what is the advice to pregnant women?
The answer is to follow the detailed advice on the NHS Choices website. Whatever women decide to do during pregnancy comes down to personal choice.
Let's look at two extremes. Keeping yourself in isolation for nine months - tricky with all those ante-natal checks - is a non-starter. The other extreme would be to go to every rock concert in town and go to as many crowded places as possible. Also not sensible.
The advice on travel and crowds is to follow a common-sense approach. If you have to get a train or bus every day to get to work, then carry on - you should not stop work because of swine flu. Equally, it is sensible to avoid crowds where possible, but this is very difficult if you live in a city.
Pregnant women are at increased risk of complications from swine flu, but the vast majority who get infected will have a mild self-limiting illness. I've dealt with the risks during pregnancy before.
The Royal College of Obstetricians and the Royal College of Midwives have .
Recent news reports have suggested that pregnant women in Australia and New Zealand have been advised to wear masks in public and to stay at home if possible to reduce the risk of swine flu infection.
The latest guidance issued by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommends that "pregnant women should avoid unnecessary exposure to crowded areas, but complete isolation at home would be regarded as extreme for most women".
Experience with the current disease pattern shows that, in most cases, swine flu tends to be a mild respiratory disease. A few cases of severe illnesses among pregnant women and infants have been reported in the UK and other countries (, 17 July). These have mostly affected women with pre-existing health problems.
Current guidance in the UK for pregnant and breastfeeding women remains unchanged. Pregnant women are advised to practice good hand hygiene by washing hands frequently with soap and water. Tissues should be used to cover the mouth and nose when sneezing and coughing, and used tissues should be disposed of promptly.
Pregnant women are advised to avoid crowded places when possible. Women who experience any symptoms of swine flu should contact the National Flu Service (by calling the Swine Flu Information Line on 0800 1 513 513).
Women with symptoms of the influenza who have been advised by the National Flu Service to take antiviral medication should do so. Once the antiviral treatment is authorised, women should arrange for a "flu friend" to collect the prescription on their behalf.
They should follow the advice to stay at home until they become symptom-free. There is currently no evidence to suggest that the use of antiviral medication might cause harm to the baby.
During pregnancy, it is also important to treat fever - a high temperature of about 38C (100F) or more. This can be controlled by taking paracetamol, which is known to be safe in pregnancy.
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