Pregnant women in the U.S. infected with the novel H1N1 influenza A virus have died at a rate six times higher than the general population. With flu season upon us, that mortality rate may escalate, so UMDNJ physicians strongly advise expectant mothers to get immunized as soon as the H1N1 vaccine becomes available.

"All pregnant women should be vaccinated," urges Dr. Gerson Weiss, professor and chair of the Department of Obstetrics, Gynecology & Women's Health at UMDNJ-New Jersey Medical School. "Pregnant women are immunocompromised, in a sense, because they have to have in themselves the ability not to reject the baby. So that's a window that the virus clearly is taking advantage of."

The U.S. Centers for Disease Control and Prevention (CDC) has named expectant mothers among those at "high risk" for serious complications from the novel H1N1 influenza A virus. Pregnant women who contract the virus may experience serious complications including early labor and severe pneumonia or the illness may prove fatal, the CDC warns.

"This is a very serious potential problem. The CDC anticipates that the death rate can be as high as 10 percent among pregnant women who get H1N1," Weiss says. "The vaccine will not be 100 percent protective, but it will certainly, for many people, mean the difference between life and death."

To women worried about getting the H1N1 vaccine out of a more general concern about taking medications while pregnant, Weiss offers this reassurance: "This vaccine is not a drug in that it does not treat, nor does it contain a live virus," he explains. "It stimulates the immune system to protect the individual so that if the real virus comes on it can fight it. And, if mom is nursing, the H1N1 vaccine may protect her and her infant." Protection received from the mother is important, says Weiss, because babies under the age of six months are too young to be vaccinated.

According to the CDC, side effects of the H1N1 flu vaccine are expected to be similar to those reported for seasonal flu vaccines - soreness, tenderness, headache, muscle aches, fever, fatigue and nausea and are expected to be mild.

Conversely, Weiss cautions that a woman unprotected against this virus may face significant risks. "Pregnant women who develop a full-blown case of H1N1 during the first trimester probably will lose the fetus," he explains. Those who contract the virus after the first trimester risk the body rejecting an ill fetus or, should severe respiratory problems develop, depriving it of oxygen, resulting in pre-term delivery or a more disastrous outcome, Weiss adds.

Expectant mothers who experience flu symptoms or an unexplained fever should immediately contact their physician, Weiss urges. "The doctor may, over the phone, prescribe treatment such as Tamiflu, which is safe, and advise you to stay away from other people or to wear a mask in public," he says.

Weiss suggests that pregnant women experiencing severe symptoms such as a high fever, trouble breathing or chest pain go to the hospital. "The emergency room should be equipped to screen you, evaluate what the problem is, and determine if you are sick enough to be admitted," he says. "Delays in evaluation or treatment are potentially extremely harmful."

Once treatment is administered, it is key for practitioners to attempt to keep track of patients who may not comply with recommended treatment, says Dr. Joseph Apuzzio, professor and director of fetal medicine at UMDNJ-New Jersey Medical School.

He is especially concerned for patients who reside in group living areas, such as shelters, who are not capable of isolating themselves as recommended from susceptible individuals such as the immunocompromised. "They should not return to these facilities until treatment has been completed," Apuzzio suggests.

The key to preventing such serious complications and widespread infections is to get vaccinated, Weiss emphasizes. "The best way to decrease the power of an epidemic is to have enough people immune so that the disease is not transmitted from person to person to person."

The University of Medicine and Dentistry of New Jersey (UMDNJ) is the nation's largest free-standing public health sciences university with nearly 5,700 students attending the state's three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and its only school of public health on five campuses. Annually, there are more than two million patient visits at UMDNJ facilities and faculty practices at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates University Hospital, a Level I Trauma Center in Newark, and University Behavioral HealthCare, a statewide mental health and addiction services network.

Source: UMDNJ