CDC Recommendations For Treatment of Swine Flu : H1N1 Influenza

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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CURRENT H1N1 INFLUENZA EPIDEMIC- RECENT UPDATE

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Influenza Virus

Swine Flu and Swine Influenza-A Pandemic

Pathogenesis Clinical Manifestations and Diagnosis

Bhushan Katira
Medical Sciences Department, Pediatric Oncall. Mumbai

Address for Correspondence: Bhushan Katira, 171/11, Basant Vihar Chs, R. B. Mehta Rd., Ghatkopar (E), Mumbai - 400077. Email: drbhushankatira@gmail.com

Treatment:

CDC recommendations for the treatment of swine flu are [13].

Home isolation:
1. Patients who develop flulike illness (i.e. fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer.
2. To seek medical care, patient should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.
3. Patients who have difficulty breathing or shortness of breath or who are believed to be severely ill should seek immediate medical attention.
4. If the patient must go into the community (e.g., to seek medical care), he or she should wear a face mask to reduce the risk of spreading the virus in the community when coughing, sneezing, talking, or breathing. If a face mask is unavailable, ill persons who need to go into the community should use tissues to cover their mouth and nose while coughing.
5. While in home isolation, patients and other household members should be given infection control instructions, including frequent hand washing with soap and water. Use alcohol-based hand gels (containing at least 60% alcohol) when soap and water are not available and hands are not visibly dirty. Patients with swine influenza should wear a face mask when within 6 feet of others at home.
Household contacts who are not ill
1. Remain home at the earliest sign of illness.
2. Minimize contact in the community to the extent possible.
3. Designate a single household family member as caregiver for the patient to minimize interactions with asymptomatic persons.
School dismissal and childcare facility closure
1. Strong consideration should be given to close schools upon a confirmed case of swine flu or a suspected case epidemiologically linked to a confirmed case.
2. Decisions regarding broader school dismissal within these communities should be left to local authorities, taking into account the extent of influenza like illness within the community.
3. Cancelation of all school or childcare related gatherings should also be announced.
4. Encourage parents and students to avoid congregating outside of the school if school is canceled.
5. Duration of schools and childcare facilities closings should be evaluated on an ongoing basis depending on epidemiological findings.
6. Consultation with local or state health departments is essential for guidance concerning when to reopen schools. If no additional confirmed or suspected cases are identified among students (or school-based personnel) for a period of 7 days, schools may consider reopening.
7. Schools and childcare facilities in unaffected areas should begin preparation for possible school closure.
Social distancing
1. Large gatherings linked to settings or institutions with laboratory-confirmed cases should be canceled (e.g., sporting events or concerts linked to a school with cases); other large gatherings in the community may not need to be canceled at this time.
2. Additional social distancing measures are currently not recommended.
3. Persons with underlying medical conditions who are at high risk for complications of influenza should consider avoiding large gatherings.
Supportive care:
Treatment is largely supportive and consists of bed rest, increased fluid consumption, cough suppressants, and antipyretics and analgesics (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs) for fever and myalgia. Aspirin or aspirin-containing products should not be administered to any confirmed or suspected ill case of swine influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs.

Severe cases may require intravenous hydration and other supportive measures. Treatment of hospitalized patients and patients at higher risk for influenza complications should be prioritized.