Michael Marcus, MD , talks about pregnancy, influenza and the H1N1 virus.
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Certain group for us to identify and could grab however is a relatively new group in the populations thinking and that’s the group of women who are pregnant. We never really thought much about pregnant women being at risk for viral infections. We’ve always known it and we’ve always known that if you’re pregnant and you get virus cell, pneumonia can occur and it can be deadly. Mortality rate is very high. But since virus cells haven't been very common in the population due to ingestion, we forgot about that piece. We’ve been reminded again before us. It’s been a significant mortality rate in women who are pregnant who catch H1N1. The reason really goes back to the protective mechanism that the body takes to allow the fetus to be carried to term. We know that there is a change in T cell responsiveness. In women, once they become pregnant, remember, the fetus is a foreign body, has an immunologically anti-genetically different protein structure. It should be a very rejective attack by our immune system, by a woman's immune system of our body. It is not because T cell responses change and are blunted to allow the pregnancy to carry beyond that first trimester and so you then have a more relative balance process. Well, remember T cells are your first line of defense in viral infection and it seems that in disinfection T cells maybe even more important in order to allow for the beginning in the process of attacking and preventing viral spread. So the blunting of that T cell response may, in fact, allow viral spread to be much more vigorous, much earlier before that humoral response is mounted.