Use flu-fighters sparingly, pregnant women first

Even as the World Health Organization is advising European countries to go easy on the Tamiflu, experts have identified one group of patients that needs antivirals, quickly and definitely. Pregnant women are at a high risk of complications from the H1N1 "swine" flu, so they need to get Tamiflu as soon as possible after diagnosis, even though the drug isn't usually recommended for use during pregnancy.

Indeed, the Centers for Disease Control and Prevention said, docs shouldn't wait for women to test positive for H1N1, but give them the Roche medication as long as they a.) exhibit symptoms and b.) have a history of likely contact with another flu patient. "Don't delay because she's pregnant," CDC medical officer Dr. Denise Jamieson told the New York Times. "At that point, the benefit of giving Tamiflu outweighs the risk."

Without antiviral support, pregnant women are more likely to develop pneumonia, premature labor and dehydration. In fact, pregnancy may be as risky for swine flu patients as asthma, diabetes, heart disease and a compromised immune system.

Meanwhile, WHO and CDC are looking toward the autumn, trying to project how the virus might develop and spread in a so-called "second wave" of H1N1 infection. Roche has significantly ramped up production after a wave of fresh orders for Tamiflu. And the company is negotiating with officials about reducing its price for the antiviral below the "pandemic price" already offered to poor countries.

- read the NYT story
- get the article on WHO's "go easy" advice from CIDRAP
- see the Roche update in the Financial Times

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