H1N1 (swine) flu

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Background

High-risk groups

  • Pregnant- increased rates of SAB, preterm labor
  • Chronic lung disease
  • Immunosuppressed
  • Cardiac
  • Diabetes mellitus

Screening

  • Individuals with an acute febrile respiratory illness (a measured temperature of 100ºF or higher and recent onset of at least one of the following: rhinorrhea, nasal congestion, sore throat, or cough) or sepsis-like syndrome.
  • HIGH PRIORITY for hospitalized patients and those at high-risk for severe disease.

Clinical Features

Differential Diagnosis

Evaluation

  • Rapid Flu nasal swab 60-80% sensitive in detecting influenza A
    • If patient is negative, severely ill and will be hospitalized, send viral culture
  • PCR is the recommended confirmatory test

Management

  • Adult: Tamiflu 75-mg capsule twice per day for 5 days
    • All hospitalized patients with confirmed, probable or suspected novel influenza (H1N1)
    • Patients who are at higher risk for seasonal influenza complications

Most effective when started within 48 hours of illness onset.

Post-exposure chemoprophylaxis

  • Tamiflu 75mg PO daily x 10 days (10 days after the last known exposure to novel (H1N1) influenza)

If the contact occurred with a patient after 7 days of symtpom onset, then chemoprophylaxis is not necessary. This is the presumed post-infectious period.

Disposition

See Also

References

Authors

Michael Holtz