Before the onset of winter season, the discussions and rumours on spread of flu, especially swine flu, are on a high, more so after the 2009 pandemic. Due to the lack of proper education and awareness, a threatened environment is created, causing undue panic!
The simple thing to be remembered is that swine flu is just like any other simple flu. People don’t need to fear; rather, just follow some precautions and be aware of the facts as to what exactly is to be worried for.
Suspicion of swine flu:
Any person with symptoms of respiratory infection plus any two of the following :
- Sore throat
- Chills and fatigue
- Bodyache /headache
- 1-7 days and peak shedding occurs on day 1
- patient is infectious from 1 day before onset of symptoms to 7 days after
- Antibodies appear after 7 days, reaching the peak at 2 weeks, and return to pre-infection level within one year.
Clinical presentation and management:
The patients are categorized into 3 categories( A/ B/ C) and management depends on the type of category of the patient.
- mild fever and cough/ sore throat with /without bodyache, diarrhoea or vomiting.
- No laboratory testing (H1N1), no medication (tamiflu), no hospitalisation required.
- Home confinement and home treatment.
- Patients with Category A symptoms along with high grade fever, sore throat and /or high risk conditions.
- No H1N1 testing,no Hospitalization
- Home treatment with isolation
- Tamiflu should be started.
High risk conditions- immunocompromised patients, patients on long term steroids, asthmatics, diabetics, patients with renal failure.
- This is the most serious category of swine flu
- Symptoms of Category A + Category B + breathlessness, chest pain, drowsiness, hypotension, bloody sputum and cyanosis.
- Testing of H1N1 required.
- Tamiflu to be started.
Monitoring for progression of symptoms should be done. The following people needs special attention:
- Young children(<5 years)
- Pregnant mothers
- Health workers
- Individuals with co-morbid conditions – heart disease, lungs disease, liver or kidney disease.
- Immunocompromised individuals.
- Real time PCR for H1N1
- Isolation of virus
Dosing of Tamiflu:
It should be given (after due prescription) two times in a day for 5 days according to weight. Tamiflu (Ostelmavir) is available as tablets and suspension( 5 ml/12 mg).
- < 15 kg – 30 mg/day
- 15-23 kg – 45 mg/day
- 24- < 40 kg – 60 mg/day
- > 40 kg – 75 mg/day
Prevention of flu:
- Education of family and close contacts on personal hygiene like hand washing.
- Home isolation for around 7 days in adults and 14 days in children. Even those in close contact should also confine themselves to home for this duration.
- Monitoring of fever for 7 days.
Vaccines available have around 80% efficacy. It is available every year after August with the prevalent strain. Hence, vaccination with the most recent vaccine should be done .Although mass vaccination is not necessary but a group of individuals who are more prone should take up the vaccine. Those who are more prone include:
- old age individuals
- children with cardiac, pulmonary, liver or kidney diseases
- patients on long term steroids
- health workers
Being aware is the best means of prevention. So the takeaway here is, don’t create or get panic, set your facts right and stay healthy.
-Dr. Anu Sharma