The doctors attending on patients with flu-like symptoms will solely determine whether any particular person’s samples should be sent for testing and other laboratory analyses. According to the guidelines, the doctors must treat people with such symptoms as mild fever, running nose, cough, cold and sore throat.
What has sent alarm bells ringing is that on Monday 16 laboratory-confirmed cases were reported in Delhi (3), Pune (6), Mumbai (2), Chennai (2) Thiruvananthapuram (1) and Gurgaon (2). The Pune cases include three more students. Since its global outbreak, tests on 2,528 persons have yielded 574 positive cases.
According to the guidelines, except for cases that are considered severe, patients should be discharged. This was not permitted under the existing guidelines according to which patients were to be admitted to isolations wards till laboratory tests proved otherwise.
Health Ministry officials felt that many people may not have voluntarily reported their ailments in the last two months for fears of being lodged in poorly maintained isolation wards in government hospitals.
The Centre’s prescribed procedure says that the samples of the suspect cases would be collected and despatched to one of the 18 notified laboratories for tests. In the beginning only two laboratories with bio-safety level-3 facilities –– National Centre for Communication Disease, Delhi, and National Institute of Virology, Pune –– conducted the tests.
However, almost a month ago, 16 additional laboratories with bio-safety-level-2+ facilities were permitted diagnosing the H1N1 virus. No private laboratories have permission to test the virus.
After the OPD check and sample test, if a patient is found positive for H1N1 with mild symptoms, he/she would be given the option of admission into the hospital or isolation and treatment at his own house. If the patient opted for home isolation and treatment, he/she would be provided with detailed guidelines and safety measures to be strictly adhered to by the entire household.
The patient would have to 
provide full contact details of the entire household. All family members and others who come in contact with the patient would be administered Tamilflu as preventive treatment.
“With the influenza season setting in, we are expecting a large number of people to come forward for clinical checking,” said Union Health Ministry joint secretary Vineet Chawdhry.
According to the guidelines, screening of passengers at airports will continue as usual.
Asked whether private hospitals would be brought into the loop, Chawdhry said a new exercise would begin to explain case management to private hospitals. Eventually though, private hospitals will be asked to refer all suspected cases to designated facilities as Tamiflu stocks will remain stockpiled only at government hospitals.
Chawdhry explained it would be incorrect to say there were no advisories for private doctors as specific advertisements with dos and don’ts have repeatedly been disseminated through the media.
Mangalore case
A 21-year-old student, who returned from Malaysia three days ago, has tested positive. This marks the first confirmed swine flu case reported in Mangalore. Dr Jagannath, District Health Officer, said a Malaysian medical student, who arrived in Mangalore three days ago, had symptoms of swine flu and has tested positive.
The swabs of the student were sent to the NICD in Delhi and the report which arrived on Tuesday confirmed the case. The student has been quarantined. She is studying in one of the medical colleges in Mangalore.
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