Swine flu pregnancy tips reissued

A suppressed immune system makes pregnant women more vulnerable

The Department of Health has attempted to clarify its guidelines to expectant mothers and parents with children under five on how best to avoid swine flu.

Its advice to practise good hygiene by washing hands and surfaces regularly has been re-issued after a woman with the virus died soon after giving birth.

The Royal College of Midwives (RCM) says all expectant mothers should avoid crowded places and unnecessary travel.

But the DoH says only the “particularly concerned” should consider the advice.

Concern over the effects of swine flu on new and expectant mothers has heightened since the death of Ruptara Miah, 39, in London’s Whipps Cross Hospital on 13 July. Her baby is said to be very ill in intensive care.

Good hygiene

Another child under six months old, who died in London, is also among the latest victims of the virus.

The refreshed DoH advice has been given greater prominence on its website.

Health experts say expectant mothers could suffer possible complications if they contract swine flu, such as pneumonia, breathing difficulties and dehydration, because they have suppressed immune systems. Young children are also vulnerable.

Most mothers-to-be with swine flu are being prescribed Relenza, an inhaled antiviral drug which treats the virus without reaching the foetus. However, where it is particularly severe, doctors can offer Tamiflu instead.

The NHS website stresses that most expectant mothers who contract swine flu will only have mild symptoms and recover within a week.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT), said that while the risks for expectant mothers were low, women needed information to make an informed decision.

“If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu.

“It is important that pregnant women know that – and particularly other members of the population know that – so that they behave responsibly and if they are sick they don’t go and put themselves close to a pregnant woman.”

If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu Belinda Phipps, NCT

The Department of Health said it advised women to plan their pregnancy carefully, but was not advising against trying to conceive.

“Mums-to-be are more vulnerable to any type of flu. It is particularly important that anyone who has existing health problems and is thinking about starting a family should talk to their GP first, as they normally would,” a DoH spokesman said.

Louise Silverton, deputy general secretary of the RCM, said women could not be expected to wait for the first wave of the pandemic to end before trying for a baby.

Speaking on BBC One’s Andrew Marr Show, Alan Johnson, the new home secretary, said an unexpected aspect of the virus was that it was attacking the young, not the elderly as with seasonal flu.

He called on parents to keep using their common sense, saying the “vast majority” had been following public health advice.

Twenty-nine people have now died in the UK after contracting swine flu – 26 in England and three in Scotland.

The government has warned that the number of deaths from the virus this winter in the UK could reach between 19,000 and 65,000.

However, during the 1999 to 2000 winter, seasonal flu deaths reached 21,000 and even during average winters there are normally anywhere between 6,000 to 8,000 deaths.

The National Flu Service will go live at the end of next week

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We asked you whether you were concerned about the effects swine flu might have on expectant mothers. Here is a selection of your comments.

I am in the third trimester of pregnancy, and I am asthmatic. I am concerned that neither Tamiflu or Relenza will be suitable for me if I contract swine flu.
Louise, Nottingham

This is such stupid advice. I am pregnant and travel to work every day on a packed Tube. How am I supposed to avoid crowded places and unnecessary travel? It’s impossible. I can’t just stop going to work can I?
Laura, Hertfordshire

My daughter has a 4yr old son who has swine flu, she is 4 months pregnant and worried in case she catches it and it harms the baby, we are also worried about the treatments used in pregnant women. There is to much contradiction going around to know what to believe.
Tina, Essex

I am currently 24 weeks pregnant and have been ill and at home for 5 days now with bad cold symptoms. After consulting the doctor by phone I was told it could possibly be swine flu but how am I to know? I am usually very level headed in these situations but not sure that not swabbing pregnant women with symptoms is wise – at least if we know if we have it we can be better informed!
Anonymous, Wales

I am 36 weeks pregnant and came into contact with Swine flu last week. I experienced a slight sore throat spoke with a nurse at NHS direct and my GP and was completely reassured that I was fine and not displaying any symptoms. There is definitely some scaremongering going on but if you seek appropriate medical advice your fears can be eased.
Jo, Romford, Essex

I have got a 14 month old child and am currently pregnant. I’m very worried we could all catch the virus as a lot of people where we live are getting it. Also it is going round schools where my niece goes. I believe there should be vaccinations soon as possible for young children and those who it could endanger more than others
Nikki, Chelmsford, Essex

Many dead in Madrid plane crash

At least 45 people have been killed after a passenger plane swerved off the runway at Madrid’s Barajas airport, Spanish officials say.

Many others were hurt when the Spanair plane bound for Gran Canaria left the runway with 166 passengers and six crew members on board.

There were reports of a fire in the left engine during take-off. TV footage showed smoke billowing from the craft.

Helicopters and fire trucks were called out to dump water on to the plane.

Dozens of ambulances went to the scene, and TV footage later showed several people being carried away on stretchers.

BBC journalist Stephanie McGovern, who is at the airport, said several planes had been seen taking off since the crash, which happened at about 1430 local time (1230 GMT).

But she added that the airport was now closed and only emergency crews and staff were being allowed into the building.

“Helicopters are continually heading to the scene, dropping lots of water… The smoke has really died down now, things seem to be more under control,” she said.

“I’ve seen around 50 ambulances. They’re still coming and going, so there may still be more casualties.”

Spanish journalist Manuel Moleno, who was near the area when the accident happened, told the BBC the plane had “crashed into pieces”.

“We heard a big crash. So we stopped and we saw a lot of smoke,” he said.

There are conflicting accounts about the number of deaths, with some reports suggesting most of the passengers on the plane may be dead.

Mr Moleno said he had seen as many as 20 people walking away from the wreckage.

The plane, which was destined for Las Palmas in the Canary Islands, came down during or shortly after take-off from Terminal Four at Barajas.

TV footage showed that the plane had come to rest in fields near the airport.

Spanair issued a statement saying that flight number JK 5022 had been involved in an accident at 1445 local time. The airline’s parent company, Scandinavian firm SAS, later said the accident happened at 1423.

According to Spain’s airport authority, Aena, the plane had been due to take off at 1300 local time.

No details of the nationalities of the passengers on board has yet been released.

But the plane was a codeshare flight with German airline Lufthansa, which said it was investigating whether German passengers were on the flight.

The aircraft was a MD82, a plane commonly used on short trips around Europe, aviation expert Chris Yates told the BBC.

He said Spanair, a subsidiary of Scandinavian carrier SAS, had a very good safety record. Reports say it was the first crash at Barajas airport, some 13km (8 miles) from central Madrid, since 1983.

People concerned for relatives or friends who may have been on board the plane should call Spanair’s helpline on: +34 800 400 200.

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Are you in the area? Did you witness what happened? Send us your comments

American deaths in Afghanistan war reach 500

KABUL, Afghanistan – The deadliest three months for American forces in Afghanistan have pushed the U.S. death toll to at least 500, forcing a war long overshadowed by Iraq back into the headlines.

Larger, more sophisticated militant attacks have also caused a sharp rise in Afghan civilian deaths — at least 472 in the first seven months of the year, most in suicide bombings, according to an Associated Press count.

In all, at least 600 Afghan civilians were killed from January through July, a 30 percent increase from the same period last year, according to AP figures compiled from coalition and Afghan officials. That includes at least 128 killed by U.S. or NATO forces.

There are about 33,000 U.S. troops in Afghanistan, the highest since the war began, meaning more troops than ever are patrolling this country’s mountainous terrain and exposed to ambushes and roadside bombs.

The U.S. military suffered 65 deaths in May, June and July, by far the deadliest three-month period in Afghanistan since the war began in 2001. The previous deadliest three-month period was in the spring of 2005, with 45 U.S. deaths.

In July, more U.S. troops died in Afghanistan than in Iraq for the month, for the first time since the Iraq war started in 2003. In all, 92 U.S. troops have died in Afghanistan this year, a pace that would surpass last year’s death toll of 111.

The spike in violence is forcing U.S. leaders, including the presidential candidates, to call for still more troops here.

More than ever, the U.S. government recognizes the situation Afghanistan “is serious and needs to be dealt with,” said Seth Jones, an Afghanistan expert at the RAND Corp., a Washington-based think tank that often does studies for the Pentagon.

“I think it is an important step that … the gravity of the situation has been recognized and that there are some steps in place to turn the tide in Afghanistan,” he said. “Whether that is successful or not is of course an open question.”

Overall, at least 500 U.S. service members have died in Afghanistan, Uzbekistan, Pakistan, Qatar and United Arab Emirates in support of the Afghan mission, according to an AP analysis based on Defense Department press releases.

“In terms of milestones, it’s important to point out that no casualty is more significant than any other,” said Pentagon spokesman Lt. Col. Mark Wright. “Each service member is equally precious, and each loss of life is equally tragic.”

The AP count is based on information from U.S., NATO or Afghan officials, often impossible to independently verify because of the remote or dangerous locations of the incidents.

The Defense Department count often lags by several days. The most recent Defense Department count, issued Saturday, showed 496 U.S. troop deaths in and around Afghanistan.

Counting coalition troops, Taliban militants and Afghan civilians, more than 3,000 people have died in violence this year, according to the AP count.

In the past, the Taliban appeared to try to minimize civilian casualties by launching its large-scale attacks primarily against U.S., NATO or Afghan troops.

But this year a February bombing at a dog fighting competition in Kandahar killed more than 100 people, mostly civilians. An attack on the Indian Embassy in Kabul last month killed more than 60.

Steven Simon, a senior fellow in Middle Eastern studies at the Council on Foreign Relations, said the recent attacks with high civilian death tolls reflect a migration of both tactics and fighters from Iraq to Afghanistan.

“The reported presence in Afghanistan of the head of al-Qaida in Iraq underscores the extent to which blowback from Iraq is being felt in Afghanistan,” Simon said in an e-mail. “At this point, al-Qaida’s leadership seems to be looking at the Afghan theater as the next big thing.”

Afghan and U.S. officials say a big reason for the spike in violence is because militaries use sanctuaries in neighboring Pakistan where they can arm and train fighters who launch attacks across the border on U.S. and Afghan forces. More al-Qaida fighters have been using the region to launch attacks than in previous years, U.S. officials say.

Gen. Mohammad Zahir Azimi, spokesman for the Afghan Defense Ministry, blamed the rise on violence principally on two factors: a peace agreement earlier this year between the Pakistan government and some militants in its tribal areas near the Afghan border, and support given by Pakistan’s intelligence agency to Taliban fighters.

Pakistan denies it is helping Taliban fighters or that it has entered into peace agreements with militants who launch attacks in Afghanistan.

Insurgent attacks have jumped by 50 percent in the first half of 2008, according to data from the Afghanistan NGO Safety Office, a Kabul-based group paid for by Western donors that advises relief groups on security.

In a report last week, ANSO said it logged 2,056 insurgent attacks in the first half of the year, a 52 percent increase from the same period last year.

The group said violence was up sharply in relatively peaceful northern and western Afghanistan and the region surrounding Kabul.

Both major presidential candidates, Democratic Sen. Barack Obama and Republican Sen. John McCain, have called for more troops to be sent to Afghanistan. President Bush has said more troops will be dedicated to the Afghan fight in 2009 but has not said how many.

U.S. military officials have said the Afghan effort needs three more brigades of troops, or about 10,500 forces.

Any new forces sent here can expect to face vicious attacks from an increasingly brazen Taliban force. Last month more than 200 militant fighters attacked a remote U.S. outpost in a dangerous and mountainous region of northeastern Afghanistan. Nine U.S. troops were killed and 15 wounded.

Even local Afghan civilians joined in on the attack, a sign the U.S. and NATO face steep challenges in their bid to win the population over to the side of the Afghan government.

“The size of the operation and the ability of the group to get support within the town was somewhat alarming, and it shows that there is clearly some concern with local Afghans, and that’s a concern because civilians are the center of gravity in a counterinsurgency,” said Jones. “The dangerous message is that there was involvement by the civilians.”