Prevention of Mother-to-Infant Transmission of Influenza during the Postpartum Period

Joseph B. Cantey; Susan L. Bascik; Nicholas G. Heyne; Jon R. Gonzalez; Gregory L. Jackson; Vanessa L. Rogers; Jeanne S. Sheffield; Sylvia Treviño; Dorothy Sendelbach; George D. Wendel; Pablo J. Sánchez

doi:10.1055/s-0032-1323585

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(03): 233-240
DOI: 10.1055/s-0032-1323585

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prevention of Mother-to-Infant Transmission of Influenza during the Postpartum Period

Joseph B. Cantey

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

Susan L. Bascik

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

Nicholas G. Heyne

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

Jon R. Gonzalez

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

Gregory L. Jackson

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

Vanessa L. Rogers

²Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

,

Jeanne S. Sheffield

²Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

,

Sylvia Treviño

³Infection Prevention, Parkland Health & Hospital System, Dallas, Texas

,

Dorothy Sendelbach

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

,

George D. Wendel

²Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

,

Pablo J. Sánchez

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

› Author Affiliations

Abstract

Objectives The optimal management of infants born to mothers with peripartum influenza infection is not known. The objective of this study is to describe our experience with a practice guideline that promotes rooming-in and breast-feeding and to determine whether infants managed in this way acquire influenza infection.

Study Design All mothers diagnosed with influenza infection within 8 days of delivery and their infants were included. Demographics, clinical characteristics, and outcome data were collected. Mothers were contacted at ~1 month after giving birth to determine if their infants had developed any signs suggestive of influenza infection.

Results Forty-two women were diagnosed with peripartum influenza over the 2003 to 2005 and 2009 to 2010 seasons. Median onset of symptoms was 3 days before delivery, and median day of diagnosis was 1 day before delivery. The 42 infants had a median gestational age of 39 weeks; none were born earlier than 35 weeks. Ninety-five percent of the infants roomed-in with their mothers. Follow-up information was available on 95% of infants by 1 month; no infants had illness suggestive of influenza through the follow-up period.

Conclusion A guideline for the management of infants born to mothers with peripartum influenza infection, based on attention to hand hygiene, antiviral treatment for mothers, and encouragement of rooming-in and breast-feeding, was not associated with mother-to-infant influenza transmission over three separate influenza seasons.

Keywords

influenza - infant - perinatal infection - infection control - breast-feeding

Full Text

References

References
1 Harper SA, Fukuda K, Uyeki TM, Cox NJ, Bridges CB. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2004; 53 (RR-6) 1-40
2 Centers for Disease Control and Prevention (CDC). Update: influenza activity—United States, 2003–04 season. MMWR Morb Mortal Wkly Rep 2004; 53: 284-287
3 Centers for Disease Control and Prevention (CDC). Update: influenza activity—United States, 2009–10 season. MMWR Morb Mortal Wkly Rep 2010; 59: 901-908
4 Irving WL, James DK, Stephenson T , et al. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG 2000; 107: 1282-1289
5 McGregor JA, Burns JC, Levin MJ, Burlington B, Meiklejohn G. Transplacental passage of influenza A/Bangkok (H3N2) mimicking amniotic fluid infection syndrome. Am J Obstet Gynecol 1984; 149: 856-859
6 Yawn DH, Pyeatte JC, Joseph JM, Eichler SL, Garcia-Bunuel R. Transplacental transfer of influenza virus. JAMA 1971; 216: 1022-1023
7 Dulyachai W, Makkoch J, Rianthavorn P , et al. Perinatal pandemic (H1N1) 2009 infection, Thailand. Emerg Infect Dis 2010; 16: 343-344
8 Pierce M, Kurinczuk JJ, Spark P, Brocklehurst P, Knight M. UKOSS. Perinatal outcomes after maternal 2009/H1N1 infection: national cohort study. BMJ 2011; 342: d3214
9 Brown AS, Derkits EJ. Prenatal infection and schizophrenia: a review of epidemiologic and translational studies. Am J Psychiatry 2010; 167: 261-280
10 Dawood FS, Fiore A, Kamimoto L , et al; Emerging Infections Program Network. Burden of seasonal influenza hospitalization in children, United States, 2003 to 2008. J Pediatr 2010; 157: 808-814
11 Dawood FS, Fiore A, Kamimoto L , et al; Emerging Infections Program (EIP) Network. Influenza-associated pneumonia in children hospitalized with laboratory-confirmed influenza, 2003–2008. Pediatr Infect Dis J 2010; 29: 585-590
12 Lopez-Medina E, Ardura MI, Siegel JD, Brock E, Sanchez PJ. 2009 influenza A in hospitalized infants at younger than 6 months of age. J Pediatr 2012; 160: 626-631
13 Takahashi N, Kitajima H, Kusuda S, Morioka I, Itabashi K. Pandemic (H1N1) 2009 in neonates, Japan. Emerg Infect Dis 2011; 17: 1763-1765
14 Fairbrother G, Cassedy A, Ortega-Sanchez IR , et al; New Vaccine Surveillance Network (NVSN). High costs of influenza: direct medical costs of influenza disease in young children. Vaccine 2010; 28: 4913-4919
15 Iyer SB, Gerber MA, Pomerantz WJ, Mortensen JE, Ruddy RM. Effect of point-of-care influenza testing on management of febrile children. Acad Emerg Med 2006; 13: 1259-1268
16 Nyqvist KH, Anderson GC, Bergman N , et al. Towards universal Kangaroo Mother Care: recommendations and report from the First European conference and Seventh International Workshop on Kangaroo Mother Care. Acta Paediatr 2010; 99: 820-826
17 Centers for Disease Control and Prevention. Considerations regarding novel H1N1 flu virus in obstetric settings. 2009. Available at: http://www.cdc.gov/h1n1flu/guidance/obstetric.htm . Accessed June 11, 2011
18 Centers for Disease Control and Prevention. Interim guidance: considerations regarding 2009 H1N1 influenza in intrapartum and postpartum hospital settings. 2009. Available at: http://www.cdc.gov/n1n1flu/guidance/obstetric.htm . Accessed June 14, 2011
19 Centers for Disease Control and Prevention. Prevention strategies for seasonal influenza in healthcare settings. 2010. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm . Accessed June 16, 2011
20 Lawrence RA, Bradley JS. Breastfeeding advice for mothers with possible H1N1 infection. AAP News 2009; 30: 11
21 Gupta M, Pursley DM. A survey of infection control practices for influenza in mother and newborn units in US hospitals. Am J Obstet Gynecol 2011; 204 (6) (Suppl. 01) S77-S83
22 Lee N, Chan PK, Hui DS , et al. Viral loads and duration of viral shedding in adult patients hospitalized with influenza. J Infect Dis 2009; 200: 492-500
23 To KK, Chan KH, Li IW , et al. Viral load in patients infected with pandemic H1N1 2009 influenza A virus. J Med Virol 2010; 82: 1-7
24 Louie JK, Acosta M, Jamieson DJ, Honein MA. California Pandemic (H1N1) Working Group. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med 2010; 362: 27-35
25 Centers for Disease Control and Prevention. Updated interim recommendations for obstetric health care providers related to use of antiviral medications in the treatment and prevention of influenza for the 2009–2010 season. 2010. Available at: http://www.cdc.gov/h1n1flu/pregnancy/antiviral_messages.htm . Accessed June 16, 2011
26 Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and associated decrease in respiratory tract infection in US children. Pediatrics 2006; 117: 425-432
27 Talaat M, Afifi S, Dueger E , et al. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerg Infect Dis 2011; 17: 619-625
28 Suess T, Remschmidt C, Schink S , et al. Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults. Epidemiol Infect 2011; 139: 1895-1901
29 Aiello AE, Murray GF, Perez V , et al. Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. J Infect Dis 2010; 201: 491-498
30 Fiore AE, Uyeki TM, Broder K , et al; Centers for Disease Control and Prevention (CDC). Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 2010; 59 (RR-8) 1-62
31 Zaman K, Roy E, Arifeen SE , et al. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 2008; 359: 1555-1564
32 Benowitz I, Esposito DB, Gracey KD, Shapiro ED, Vázquez M. Influenza vaccine given to pregnant women reduces hospitalization due to influenza in their infants. Clin Infect Dis 2010; 51: 1355-1361
33 Schade CP, Hannah KL. Impact of the 2004 influenza vaccine shortage on repeat immunization rates. Ann Fam Med 2006; 4: 541-547
34 Russell KL, Ryan MA, Hawksworth A, Freed NE, Irvine M, Daum LT. NHRC Respiratory Disease Surveillance Team. Effectiveness of the 2003–2004 influenza vaccine among U.S. military basic trainees: a year of suboptimal match between vaccine and circulating strain. Vaccine 2005; 23: 1981-1985
35 Jones TF, Ingram LA, Craig AS, Schaffner W. Determinants of influenza vaccination, 2003–2004: shortages, fallacies and disparities. Clin Infect Dis 2004; 39: 1824-1828
36 Lu P, Bridges CB, Euler GL, Singleton JA. Influenza vaccination of recommended adult populations, U.S., 1989–2005. Vaccine 2008; 26: 1786-1793
37 Centers for Disease Control and Prevention (CDC). Interim results: influenza A (H1N1) 2009 monovalent vaccination coverage—United States, October–December 2009. MMWR Morb Mortal Wkly Rep 2010; 59: 44-48
38 Poehling KA, Szilagyi PG, Staat MA , et al; New Vaccine Surveillance Network. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 2011; 204 (6) (Suppl. 01) S141-S148