Guidance on Risk Categorization of Seasonal Influenza A H1N1 Cases during Screening
Introduction
Ministry of Health & Family Welfare, Government of India has released guidelines for screening, testing and isolation;to prevent and contain outbreak of Influenza-A H1N1 virus.
Screen all individuals seeking consultations for flu like symptoms at healthcare facilities both Government and private or should examined by a doctor. There after, they should be categorized and managed as given below:
Category A
Symptoms: Mild fever plus cough / sore throat with or without bodyache, headache, diarrhoea and vomiting
Treatment: Do not require Oseltamivir and treat for the symptoms mentioned above.
Assessment: Monitor patients for their progress and reassess at 24 to 48 hours. No testing of the patient for H1N1 is required.
Management: Patients should confine themselves at home and should avoid mixing up with public and high risk members in the family.
Category B
Symptoms: Category-B (i): All the signs and symptoms under Category-A plus if the patient has high grade fever and severe sore throat
Category-B (ii): In addition to all the signs and symptoms under Category-A, individuals having one or more of the following high risk conditions:
- Children with mild illness but with predisposing risk factors
- Pregnant women
- Persons aged 65 years or older
- Patients with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS
- Patients on long term cortisone therapy
Treatment: Category-B (i): May require home isolation and oseltamivir; Category-B (ii): shall be treated with oseltamivir
Assessment: No tests for H1N1 required for Category-B (i) and (ii).
Management: All patients of Category-B (i) and (ii) should confine themselves at home and avoid mixing with public and high risk members in the family. Prescribe Broad Spectrum antibiotics as per the Guideline for Community-acquired pneumonia (CAP).
Category C
Symptoms: All signs and symptoms of Category-A and B plus if the patient has one or more of the following:
- Breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails
- Children with influenza like illness who had a severe disease as manifested by the red flag signs (Somnolence, high and persistent fever, inability to feed well, convulsions, shortness of breath, difficulty in breathing, etc).
- Worsening of underlying chronic conditions
Assessment and Management: All these patients require testing, immediate hospitalization and treatment.
Ministry of Health & Family Welfare, Government of India
mohfw.gov.in/showfile.php?lid=307.Last accessed on 26th February 2015
