Treatment norms revised

Fighting the flu: Only serious patients to be hospitalised

According to the new guidelines—finalised after a marathon health ministry meeting that ended late in the night— only patients with serious symptoms require testing and immediate hospitalisation.

Health Minister Ghulam Nabi Azad chaired the five-hour meeting with 22 doctors, medical scientists and officials involved with managing the H1N1 epidemic. The new guideline stipulates all individuals seeking consultation in private or government hospital will be divided into three categories and treated accordingly.

Category A will be patients with mild fever plus cough or sore throat with or without body ache, headache, diarrhoea and vomiting. They do not require Tamilflu (Oseltamivir) and should be treated for the symptoms mentioned above.  

Category A patients should be monitored for their progress and reassessed at 24 to 48 hours by the doctor.  While no H1N1 testing is required, they should stay at home and avoid mixing up with public and high risk members in the family.  

Category B patients would be those who in addition to Category-A symptoms will have high grade fever and severe sore throat. They may require home isolation and Tamilflu but again no H1N1 test. Moreover, the high risk population showing above symptoms will come under Category-B. The risk group involves children less than 5 years, pregnant women, people aged 65 years or more, and patients with disease of the lung, heart, liver and kidney. Patients on long-term cortisone therapy and those with blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS will come under this group too, said an official.

All Category-B patients should confine themselves at home and avoid mixing with public and high risk members in the family. Category-C will be the most vulnerable lot and are at risk the most. To come under this category, besides the above mentioned symptoms, the patient should have one or more of the following symptoms:

Chronic conditions

Breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails. Irritability among small children, refusal to accept feed.

Worsening of underlying chronic conditions.

Only category-C patients require H1N1 testing, immediate hospitalisation and treatment, the official said. The overhaul in guidelines was required because the government has changed its strategy from containment to treating the disease at the community level.

With more than 1,300 cases, the virus has established itself in the community. The guidelines have been finalised after discussing the procedure and protocols developed by the WHO Geneva, Centre for Disease Prevention and Control, Atlanta and National Health Service, UK.