In the light of seasonal influenza cases, the Directorate of Public Health (DPH) and Preventive Medicine has issued guidelines for the categorisation of seasonal influenza cases during screening for home isolation, testing, treatment and hospitalisation.
It has asked all deputy directors of health services to follow the guidelines scrupulously without deviation and lapses.
Patients with fever and cough/sore throat are not only symptomatic for COVID-19 and may be tested for seasonal influenza. This was primarily to arrive at the right diagnosis and treatment.
Influenza-like illness is an acute respiratory infection (sudden cough and sore throat) with measured fever of 100. 4 ° F or higher with the onset within the last 10 days. The other associated symptoms were muscle or body aches, headaches, fatigue, vomiting and diarrhoea (more common in children than adults), runny or stuffy nose.
All individuals seeking consultations for flu-like symptoms should be screened at healthcare facilities, both government and private, or examined by a doctor and categorised into A, B and C. To prevent and contain outbreaks of influenza, guidelines for screening, testing and isolation should be followed.
Patients with mild fever and cough/sore throat with or without body ache, headache, diarrhoea or vomiting will be categorised as Category A. Testing such patients is not required and they do not require Oseltamivir. They should be monitored for their progress and re-assessed at 24 to 48 hours by the doctor.
In addition to all signs and symptoms of Category A, if the patient has high-grade fever (102 ° F or higher) and severe sore throat with one or more of the following high-risk conditions, they are classified as Category B— aged 65 and above, pregnant, infants and children aged five years and below, chronic respiratory disease, chronic heart, kidney, liver, neurological disease, diabetes, blood disorders, persons with immunosuppression, extreme obesity and malignancy.
While testing for influenza was not required, they should receive Oseltamivir along with symptomatic treatment.
Along with signs and symptoms of categories A and B, if a patient has one or more of the following symptoms of breathlessness, haemoptysis, altered mental status, somnolence and poor feeding (in children), seizures, decreased urine output, persistence or worsening of initial symptoms beyond 72 hours, worsening of chronic conditions such as diabetes, chronic kidney disease and and signs of tachypnoea, oxygen saturation level of less than 90%, hypotension, reduce urine output and cyanosis – are classified as Category C. They should be tested and put on empirical antiviral therapy while results are pending. There are 30 AH1N1 approved laboratories in the State.