New Swine Flu Guidelines

On 14 th august, Friday night, after facing flake for the past two weeks on the bungled handling of Swine Flu epidemic in India, the government has come up with a better set of guidelines.The new guidelines allow ALL doctors to treat for Swine Flu ( earlier only designated hospitals and doctors could treat Swine flu!!)The guidelines were finalized after a five-hour meeting chaired by Health and Family Welfare Minister Ghulam Nabi Azad.

The patients have been categorized as follows:

• Category A: Patients with mild fever plus cough/sore throat with or without body ache, headache, diarrhoea and vomiting. 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. No testing of the patient for H1N1 is required. Patients should confine themselves at home and avoid mixing with the public and high risk members in the family.( I agree with this)

• Category B: (i) In addition to all the signs and symptoms of Category A, if the patient has high grade fever and severe sore throat, he/she may require home isolation and Oseltamivir; (ii) In addition to all the signs and symptoms of Category A, individuals having one or more of the following high risk conditions shall be treated with Oseltamivir: children under five, pregnant women, those above 65 years, those with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS; Patients on long term cortisone therapy. No H1N1 tests are required for Category-B (i) and (ii). Such patients should confine themselves at home and avoid mixing with the public and high-risk members in the family.( I think all such cases be tested for H1N1, and antiviral therapy started without delay)

• Category C: In addition to the symptoms of Categories A and B, if the patient has one or more of the following: 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. Such patients require testing, immediate hospitalisation and treatment.( All such patients should be started on antivirals without even waiting for test results!!, its already late!!)

During the meeting, various guidelines and protocols developed by the World Health Organisation, Geneva, the Centre for Disease Prevention and Control, Atlanta, United States, and the National Health Service, United Kingdom, were also discusse