H1N1 (swine) flu

High-risk groups

1. Pregnant- incr rates of SAB, preterm labor
2. Chronic lung disease
3. Immunosuppressed
4. Cardiac
5. DM

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.

Diagnosis

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

Treatment

1. All hospitalized patients with confirmed, probable or suspected novel influenza (H1N1)
2. Patients who are at higher risk for seasonal influenza complications

Most effective when started within 48 hours of illness onset.

Adult: 75-mg capsule twice per day for 5 days

Post-exposure chemoprophylaxis

1. 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.