Influenza cases: DPH issues guidelines for testing and treatment

CHENNAI: The Directorate of Public Health and Preventive Medicine has informed all the Deputy Directors of Health Services that the patients with fever, cough and sore throat are not only symptomatic of Covid but also may be tested for seasonal influenza.

The directorate, in its guidelines on the categorization of AH1N1 seasonal influenza cases during screening for home isolation, testing, treatment and hospitalisation, has also recommended the dosage and duration of influenza antiviral medications.

The clinical symptoms of influenza include an acute respiratory infection, with sudden cough and sore throat, accompanied by a measured fever of 100.4 or above with onset within the last 10 days.

Other symptoms include muscle or body ache, headache, fatigue, vomiting and diarrhoea, and running or stuffy nose.

The Directorate has stated that the individuals seeking consultations for flu-like symptoms should be screened at healthcare facilities, both government and private or examined by a doctor and categorised as a mild, uncomplicated and complicated category.

“Patients with mild fever, cough, and sore throat with or without body aches, headache, diarrhoea and vomiting will be categorised in the mild category. Testing of such patients for Influenza is not required. They do not require Oseltamivir and should be treated for the abovementioned symptoms. The doctor should monitor the patient’s progress and reassess at 24 to 48 hours. Patients should confine themselves at home and avoid mixing up with public and high-risk members in the family,” the guidelines stated.

Apart from the symptoms in the mild category, if the patient has a high-grade fever of 102 Fahrenheit or more and a severe sore throat, they belong to the uncomplicated but high-risk category. If the patient is aged 65 years or more, pregnancy (including up to two weeks post-partum), infants and children aged below 5 years (especially those below 2 years of age), chronic respiratory disease, heart, kidney, liver or neurological disease. Several other comorbid conditions such as diabetes mellitus, blood disorders, persons on immunosuppression, extremely obese and malignancy are also categorised as high-risk categories.

People at high risk for influenza complications do not require testing, but they should receive Oseltamivir along with symptomatic treatment. All the patients in this category should confine themselves at home and avoid mixing with the public and high-risk members of the family.

Meanwhile, the patients with symptoms of breathlessness, hemoptysis, altered mental status, seizures, decreased urine output, worsening of previous symptoms and worsening of comorbid conditions belong to the category of complicated influenza cases.

These patients should be tested for RT-PCR and a total of 30 AH1N1 approved labs are functioning in Tamil Nadu. They should be put on empirical antiviral therapy (oseltamivir) under hospital care, while test results are pending.

At least 282 active cases of influenza in State, says Ma Su

At least 282 influenza cases are being treated in Tamil Nadu, Health Minister Ma Subramanian said on Thursday.

Inspecting the fever ward at the Institute of Child Health, he said the cases of seasonal flu after the recent rains are seeing a spike and called for a vigil.

Among the 282 cases, 13 people are receiving treatment in government hospitals, 215 in private hospitals and 54 in isolation at home. He said there are no cases of influenza at the Egmore Children’s Hospital. The Health Minister denied the lack of availability of beds in government or private hospitals in the State.

“The hospital has a total of 837 beds. The number of children receiving treatment in this hospital is 637. Out of these 637 children, only 129 are under treatment for fever and 18 of them have dengue fever. The remaining 121 have only mild fever,” a release from the health department stated. “The rise in the cases of seasonal flu is common after rains and there is no need to panic. There were reports of unavailability of beds at ICH, but it is completely wrong and there are adequate beds available. None of the children admitted to ICH has influenza but normal fever,” the minister said.

He said the common symptoms include cough, fever or sore throat and it is important to be cautious when children have these symptoms. He emphasized the need to maintain social distancing and practice handwashing to stay safe from infections and prevent the spread of infections.

He further added that the hospitals and district healthcare officials have been instructed to follow the treatment recommendations and irrespective of the type of infection, safety precautions should be taken based on the type of case as per the categorisation and adequate treatment should be followed.

“A drug called oseltamivir is given in the early stages of the flu. All drug stores in Tamil Nadu have been advised not to dispense medicines without a doctor’s prescription. All hospitals and laboratories have been instructed to immediately inform the health officials about the confirmed cases of influenza in private medical laboratories,” he added.

Currently, the State has 243 cases of dengue among children. The necessary medications and beds are available in urban and rural primary health centres for the treatment of all these cases, he added. Health Minister said that 15,853 fogging machines and 80,561 litres of mosquito repellants and other drugs are in stock. In the hospitals, necessary medicines and tablets are provided under the categories of normal flu, H1N1 flu and dengue fever. Therefore, when the children in their home suffer from physical ailments such as fever, sneezing, cough, headache, body ache, or sore throat, they should consult the doctors to assess the type of illnesses and provide treatment accordingly.