Centre issues fresh guidelines on swine flu

With swine flu cases across India rising sharply, the Union Health Ministry on Saturday issued fresh guidelines specifying screening and testing module for patients, to contain the disease in the country.

The guidelines were finalised at a high-level meeting chaired by Health Minister Ghulam Nabi Azad on Friday night in connection with the various actions taken by the government for containment and mitigation of H1N1 cases across the country. During the meeting that lasted for more, than five hours till 10 pm on Friday night, the health minister also discussed various guidelines and protocols developed by the World Health Organisation in Geneva, the Centre for Disease Prevention and Control in Atlanta, United States and the National Health Service in United Kingdom.

The meeting was attended by eminent experts from public and private  hospitals/organisations besides senior officers of the Health Ministry and the Directorate General of Health Services. As per guidelines, all individuals seeking consultation for flu-like symptoms would be screened at healthcare facilities -- both government and private -- or examined by a doctor and will be categorised broadly under three categories A, B and C depending on their health status, as per an official release. They will be given treatment and isolated as specified in the guidelines.

Patients with mild fever plus cough/sore throat with or without body ache, headache, diarrhoea and vomiting will be categorised as Category-A. They do not require Oseltamivir and should be treated for the symptoms mentioned above. The patients should be monitored for their progress and reassessed after 24 to 48 hours by the doctor. For this category, no testing of the patient for H1N1 is required.

Patients should confine themselves at home and avoid mixing up with public and high- risk members in the family. Category B has two subcategories. Category BI is for those patients who have high grade fever and severe sore throat, in addition to all the signs and symptoms mentioned under Category-A.

They may require home isolation and Oseltamivir. Category BII is for those, who in addition to all the signs and symptoms mentioned under Category-A, have one or more of the following high risk conditions like children less than five years old, 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 cortisone therapy.

They shall be treated with Oseltamivir but no tests for H1N1 is required for Category-B (I) and (II). However, all patients of Category-B (I) and (II) should confine themselves at home and avoid mixing with public and high-risk members in the family.

Category C is for patients, who in addition to the above signs and symptoms of Category-A and B, have one or more of the following problems like breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails, irritability among small children, refusal to accept food, worsening of underlying chronic conditions.

All these patients mentioned above in Category-C require testing, immediate hospitalisation and treatment. The release said that these guidelines will be reviewed and revised from time to time as per need and on the basis of the spread of the disease.