swine flue

Post pandemic period H1N1 -2009 : 

Post pandemic period H1N1 -2009 Virus expected to continue as seasonal virus. Vigilance needed on the part of providers. Continue to affect younger age group. Risk to groups as during pandemic to continue. Primary viral pneumonia as complication—difficult to treat. Local outbreaks expected-impact on public.

Case description : 

Case description Fever, cough, sore throat, rhinorrhea, muscle pain, malaise. No dyspnoea. All / one symptoms. G.I. symptoms—diarrhea, vomiting especially in children—no dehydration.

Complicated/severe influenza : 

Complicated/severe influenza Dyspnoea, cyanosis, hypoxia, tachypnoea. Radiological signs of pneumonia. CNS– Encephalopathy, encephalitis. Severe dehydration. Secondary complications—ARF, Multi-organ failure, septic shock. Rhabdomyolysis, myocarditis. Exacerbation of ch illnesses-asthma, COPD, diabetes, renal &CVS diseases.

S/S of progressive disease : 

S/S of progressive disease Persistent high fever x 3 days. Dyspnoea, cyanosis. Colored sputum, chest pain, low BP. Child— fast, labored breath. Hypoxia—pulse oximetery. Altered mental status, un consciousness, drowsy, convulsions, confusion, paralysis, severe weakness. Dehydration-dizziness, low urine o/p, lethargy.

Categorization : 

Categorization All influenza cases to be examined/ screened.

Category A : 

Category A Mild fever, cough, sore throat with/without body aches, head ache, diarrhea, vomiting. Oseltamivir-- not required. HINI Testing –not required. Observation x 24-48 hours. Isolation at home.

Category B : 

Category B All s/s of cat A. High fever, severe sore throat. High risk—age<5 &>65 years, pregnancy, ch. Illnesses— lung, heart, liver,kidney, blood, CNS, diabetes, cancer, HIV. No H1N1 test– required. Isolation required. Oseltamivir required.

Category C : 

Category C Dyspnoea, Drowsy, Chest pain, low BP, colored sputum, cyanosis. Child—irritable, refuse to take food. Worsening of chronic conditions.

Treatment : 

Treatment By weight: <15 kg ------ 30 mg BD x 5 Days. 15—23 kg—--- 45 mg. >23—40 kg-----60 mg. >40 kg --------75 mg. For infants:<3 months-------12 mg BD X 5 Days. 3—6 months-----20 mg. 6—11 months—25 mg.

Supportive therapy : 

Supportive therapy IV fluids. Parental therapy. Antibiotics. PCM / Ibuprofen. No smoking, plenty fluids, decongestants, saline nasal drops, lozenges, steam. No salicylates. Oxygen therapy, ventillator.

Prophylaxis : 

Prophylaxis By weight: <15 kg---------30 mg. x10 day ( after the date of last exposure.) 15-<23kg-------45 mg. 23--<40 kg-----60 mg. >40 kg -----------75 mg. For infants: <3 months– not required. 3—5 months--20 mg OD. 6—11 months---25 mg OD.

Three layer masks : 

Three layer masks Screening area, isolation ward, mortuary. Security, suspect/ confirmed cases. Close family contacts. Ambulance staff.

N 95 : 

N 95 Critical care units. Laboratory. Procedure.

Vaccination : 

Vaccination Single dose—0.5 ml (15 micro grame) I/M. For staff only.

Slide 15: 

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