Category Based Management of Swine Flu H1N1

Current Guidelines for Management of Seasonal Influenza based on their clinical categories was issued Ministry of Health & Family Welfare in April 2016

Category- A 

  • Patients with mild fever plus cough / sore throat with or without bodyache, headache, diarrhoea and vomiting.
  • No testing of the patient for Influenza is required.
  • They do not require Oseltamivir
  • Should be treated symptomatically only 
  • Should be confined to home and should be reassessed at 24 to 48 hours by the doctor.

Category-B : This category has 2 groups-

  • Category B(i) – Category-A symptoms PLUS high grade fever and severe sore throat
    • Oseltamivir may be given in this group as per clinical discretion of the physician
  • Category B(ii)- Category-A symptoms PLUS individuals having one or more of the following high risk conditions 
  • Pregnant women
  • Persons aged 65 years or older
  • Patients with lung diseases, heart disease, liver disease 
  • Kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS
    • Patients on long term systemic steroids therapy(not Inhaled steroids)
    • Oseltamivir should be given in this group
  • No tests for Influenza is required for Category-B (i) and (ii).
  • Category-B patients should confine themselves at home and avoid mixing with high risk members in the family. 
  • Broad Spectrum antibiotics as per the Guideline for Community- acquired pneumonia (CAP) may be prescribed in Category B(ii) patients

Category-C 

Category-A or  B patients PLUS has one or more of the following: 

  • Breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolorationof nails
  • Children with red flag signs (Somnolence, high and persistent fever, inability to feed well, convulsions, shortness of breath, difficulty in breathing, etc). 
  • Worsening of underlying chronic conditions. 

All these patients mentioned above in Category-C require testing, immediate hospitalization in isolation wards and treatment with Oseltamivir.

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