This sheet is about having H5N1 flu in a pregnancy or while breastfeeding. This information is based on published research. It should not take the place of medical care and advice from your healthcare providers.
What is H5N1 flu?
The flu (influenza) is an infection of the breathing system, including the nose, throat, and lungs. The flu is caused by a group of viruses called influenza virus. H5N1 flu is caused by a type of avian (bird) influenza virus mainly found in wild birds, poultry, and U.S. dairy cows.
How do you get H5N1 flu?
People can get H5N1 flu from infected animals. This can happen through contact with an infected animal’s saliva, mucus, feces (poop), or milk. A person can become infected if the virus gets into their eyes, nose, and mouth, or if they breathe it in. Most people are not at a high risk of getting H5N1 flu. However, people who work with animals or animal products, or who have close contact with animals, have a higher chance of being exposed to H5N1 flu. H5N1 flu can be spread from person to person, but this is rare.
What are the symptoms of H5N1 flu?
Common symptoms of H5N1 flu include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, tiredness, eye redness, shortness of breath, and trouble breathing. Less common symptoms include diarrhea, nausea, vomiting, and seizures. Severe H5N1 flu can be life-threatening. Pregnant women have a much higher chance of developing severe symptoms and dying from H5N1 flu than those who are not pregnant.
People who think they may have been exposed to H5N1 through infected birds, other animals, or people should watch for symptoms, including breathing problems and eye redness, for 10 days after exposure. Anybody who develops symptoms after exposure to H5N1 should seek medical care right away. It is important to treat H5N1 flu as early as possible.
How can I protect my pregnancy from H5N1 flu?
To help prevent H5N1 flu, the Centers for Disease Control and Prevention (CDC) recommends avoiding contact with sick or dead animals, including wild birds, poultry (such as poultry chickens, turkeys, ducks), other domesticated birds, and other domestic and wild animals, including cows. It is also recommended to avoid contact with animal poop, bedding, litter, unpasteurized (“raw”) milk, and materials that have been touched or are close to infected animals.
People who work with or have contact with animals, such as poultry and livestock workers, veterinary staff, bird flock owners, and emergency responders, should use appropriate protective gear. Personal protective equipment (PPE), such as thick disposable gloves, protective clothing, and a mask, should be worn when handling or working near sick birds, livestock, dead animals, animal poop, litter, raw milk or surfaces and water that may be contaminated. All workers should wear PPE whether they are pregnant or not. Properly washing hands is also very important. For more information visit the CDC’s page on reducing risk for people working with or exposed to animals: https://www.cdc.gov/bird-flu/prevention/worker-protection-ppe.html.
MotherToBaby also has a general sheet on working as a veterinarian or veterinarian Technician at https://mothertobaby.org/fact-sheets/vet-vettech/ and a general sheet on workplace safety tips at https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/.
Poultry, eggs, and beef should be cooked to a safe internal temperature to kill bacteria and viruses. Pasteurized milk and foods made with pasteurized milk are not expected to be contaminated with H5N1 flu. Unpasteurized “raw” milk and unpasteurized milk products (such as soft cheeses, ice creams, and yogurts) can be contaminated with H5N1 virus and other bacteria. Pasteurization kills H5N1 virus.
How can I find out if I am infected with H5N1 flu?
If you think you are infected with H5N1, seek medical care as soon as possible. A healthcare provider can order tests to check for H5N1 infection. At-home and other rapid flu tests will not be able to tell the difference between seasonal flu and H5N1 flu.
What should I do if I think I have been infected with H5N1 flu?
The CDC has recommended that anyone with suspected or confirmed H5N1 flu receive an antiviral treatment for H5N1 as soon as possible. The World Health Organization (WHO) also recommends antiviral treatment for pregnant women with suspected or confirmed H5N1 flu, regardless of how far along they are in pregnancy.
If you think you may have H5N1 flu, seek medical care right away. Pregnant women with H5N1 flu have a higher chance of having severe symptoms and death. The benefits of antiviral therapy are expected to outweigh any potential risks. There is no vaccine available for H5N1 flu. MotherToBaby has a general sheet on antiviral medications for the flu here: https://mothertobaby.org/fact-sheets/antiviral-medications-treatprevent-influenza-the-flu-pregnancy/.
I have H5N1 flu. Can it make it harder for me to become pregnant?
It is not known if H5N1 flu can make it harder to get pregnant.
Does having/getting H5N1 flu increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if H5N1 flu can increase the chance of miscarriage. In the reports of about 30 pregnant women with H5N1 flu, most of the babies did not survive. This was often because the mother became very sick.
Does having/getting H5N1 flu increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like H5N1 flu, might increase the chance of birth defects in a pregnancy. Because H5N1 flu is rare in people, no studies have looked at whether it increases the chance of birth defects.
Fever is a possible symptom of H5N1 flu. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended as an option to reduce fever in pregnancy. If you have H5N1 flu and develop a fever, talk with your healthcare provider about the best way to treat your fever. For more information about fever and pregnancy, see the MotherToBaby sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/ and a sheet on acetaminophen here: https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.
Would having/getting H5N1 flu increase the chance of other pregnancy-related problems?
In the small number of pregnancies with H5N1 flu that have been reported, nearly all the babies who were born alive were born preterm (birth before week 37). Because they were born early, most were also born with low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). In many of these cases, the babies were delivered early on purpose because the mother was very sick.
Can H5N1 flu be passed to the baby during pregnancy or at the time of delivery?
Sometimes an infection can pass from a pregnant woman to the developing baby during pregnancy. This is called vertical transmission. Vertical transmission has been reported with H5N1 flu in pregnancy, but this appears to be rare. Because H5N1 flu is so rare in people, there is not enough information to know at what point during pregnancy vertical transmission is most likely to happen.
Does having/getting H5N1 flu in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if H5N1 flu can increase the chance of behavior or learning issues for the child.
Breastfeeding while I have H5N1 virus:
It is not known if H5N1 virus can pass into human breast milk. No baby has been reported to get H5N1 flu from breastfeeding. The CDC encourages women to continue to breastfeed or provide breast milk for their babies even if they have the flu. Breast milk has antibodies (proteins made by the immune system), which may help protect baby from getting sick with the flu. Women with H5N1 flu may feel too sick to breastfeed. When possible, the CDC recommends expressing (pumping) milk for the baby when possible. Some women with the flu might make less milk while they are sick. Be sure to talk to your healthcare provider about all your breastfeeding questions.
While you are sick, it is important to try to protect the baby from getting sick. Wash your hands with soap and water before holding your baby. Avoid coughing or sneezing on your baby. Cover your mouth/nose with a tissue when you cough or sneeze, throw the tissue away, and then wash your hands. If possible, have someone who is not sick help care for your baby while you are sick. The CDC has more information on the flu and breastfeeding at https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/flu.html. If you think your baby has symptoms of H5N1 flu, contact your child’s healthcare provider.
If a man has H5N1 flu, can it make it harder to get a partner pregnant or increase the chance of birth defects?
Having a fever from an infection, such as H5N1 flu, might temporarily reduce the number of sperm and how sperm move, which could affect male fertility (ability to make healthy sperm) during that time. If you have or are suspected to have H5N1 flu, try to avoid close contact with your pregnant partner while you are sick to reduce the chance of spreading the infection. In general, exposures that men have are less likely to increase the risk to a pregnancy. For more general information, please see the sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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