CHENNAI: Due to an increase in the fever cases reported in the State, especially influenza like illness, the Director of Public Health and Preventive Medicine has instructed all the Deputy Directors of Health Services to follow the guidelines on prevention and control of influenza Like illness and seasonal flu.

Stating that seasonal Influenza may affect all age groups, he mentioned that the incidence is higher in younger children and elderly above 65 years and has an incubation period of 1 to 4 days. The sudden onset of fever peaking at 38.4 degree Celsius can go up to 41 degree Celsius C, typically lasting 3 days, with symptoms of chills, body ache, sore throat, non-productive cough, runny nose and headache.

As per the protocols, the persons suffering from flu like symptoms should be categorized as Category A, B and C, with category A consisting of persons with mild fever, cough or sore throat with or without body ache, headache, diarrhoea and vomiting. There is no need to test for influenza for this category and the Oseltamavir is not required for treatment. The cases should be managed under home isolation and symptomatic management needs to be done.

The category B consists symptoms of category A accompanied with high grade fever or severe sore throat, which includes children less than 5 years, persons above 65 years, pregnant women, persons with co-morbities and persons with Immuno-deficiency on long term steroid therapy. As per the protocol, there is no need to test for Influenza but Oseltamavir can be given as per the schedule plus broad spectrum antibiotics and it can be managed under home isolation.

The category C includes the patients with symptoms of category A or B, ane adults with breathlessness, chest pain, drowsiness, fall in blood pressure, sputum in blood, bluish discolouration of nails and children with flu like illness like plus somnolence, high and persistent fever, inability to feed well, convulsions, shortness of breath, difficulty in breathing etc. The category C patients need to be tested for Influenza with RT PCR.

Oseltamavir needs to be administered as per the schedule plus broad spectrum antibiotics, and they also need immediate hospitalization and treatment.

The discharge policy states that adult patients should be discharged 7 days after symptoms subsided and children should be discharged 14 days after symptoms subsided. The medical personnel involved in any aerosol generating procedures like suction, intubation, nebulization, critical care facility, ambulance staff, laboratory etc have been asked to use N95 mask.

DPH has recommended vaccination for influenza for health care workers, including all medical and paramedical personnel working in casualty, emergency department, ICU and isolation wards, screening centres and laboratory personnel, pregnant women, persons with chronic illnesses and immunocompromised.

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