Categorization of patients based on risk:
Category A
Symptoms/ Signs: Mild fever + sore throat/ cough with/ without bodyache, headache, diarrhea and vomiting.
Treatment: Symptomatic
Oseltamivir: Not required
H1N1 testing: Not required
Monitoring: 24-48 hours by a doctor.
Prevention: Patients should stay at home and avoid mixing with public and high risk members of family.
Category B
This has two sub-categories:
i) In addition to signs and symptoms of Category A, high grade fever and sore throat is present.
May require home isolation and Oseltamivir
H1N1 testing: Not required
ii) In addition to signs and symptoms of Category A, one or more of the following high risk categories is present:
- Children with mild illness but with predisposing risk factors.
- 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.
Treatment: Broad spectrum antibiotics as for Community Acquired Pneumonia
Oseltamivir
H1N1 testing: Not required
Prevention: All patients of category B (i) and (ii) should confine themselves at home and avoid mixing with general public; high risk members of their family
Category C
In addition to signs and symptoms of category A and category B, 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
- Children with influenza like illness who had a severe disease as manifested by the red flag signs (Somnolence, high and persistent fever, inability to feed well, convulsions, shortness of breath, difficulty in breathing, etc)
- Worsening of underlying chronic conditions.
Treatment: Immediate hospitalization and treatment
H1N1 testing: Required
Useful links:
Technical guidelines (Ministry of Health and Family Welfare)
http://mohfw.gov.in/index1.php?lang=1&level=1&sublinkid=4987&lid=3070
Risk categorization (Revised 11/2/2015)
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