Take Tamiflu for five days if you test positive

The H1N1 virus has claimed one life in Gujarat with Pravin Patel, an NRI, succumbing to the virus at Civil Hospital in the early morning of Sunday. Dr Sapan Pandya, a family physician, tells DNA readers what treatment should be given to people who have tested positive or are probable cases.

If a person is suspected of having H1N1 infection, he or she should to quarantined at government tertiary hospital immediately. The samples (blood, nasal swab or saliva) should be taken and sent for pathological tests at NIV, Pune, or NICD, New Delhi. In Ahmedabad, last week a centre has been started at BJ Medical College and results are available in 5-6 hours by real time PCR. 

If tested positive, he or she has to be put on medication immediately.  H1N1 flu is sensitive to antiviral drugs oseltamivir (Tamiflu- a brand name of ROCHE) and zanamivir (Relenza - another brand name).

These antivirals should be continued for five days. The patient should be kept in isolation, he should be given adequate physical rest, and should consume plenty of fluids, including water. Control of body pain and fever can be achieved with paracetamol.

A person having swine flu develops complications such as pneumonia, acute respiratory distress syndrome (ARDS) and acute respiratory failure. Treatment of complications includes supportive care for organ dysfunctions, antibiotics and general nursing care.

It is recommended that the antiviral drugs are used only for people who:
Have confirmed, probable or suspected H1N1 influenza, especially if they are at higher risk of complications;

Are household contacts who are at high risk for complications of influenza (such as persons with certain chronic medical conditions, persons who are 65 or older, children younger than 5 years, and pregnant women) of a confirmed, probable or suspected case;

Are schoolchildren at high risk for complications of influenza (children with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed, probable or suspected cases;

Have recently travelled from or live in area where H1N1 flu cases have been confirmed, if they are at high risk of complications;

Work in certain healthcare fields, particularly if they are at high risk of complications.
The antivirals are not available for private practitioners. They can be prescribed only at government tertiary hospitals.

Despite government plans to limit the spread of H1N1 virus at entry-points, cases are showing up. There are many factors. The disease may be in incubation period during which the patient shows no symptoms.

During the screening at airports, such patients may show no symptoms. Even on thermal scanners kept at airports, the symptoms can be missed. Besides, infected persons avoid self-declaration to avoid being quarantined!
 (Dr Sapan Pandya is secretary, A’bad Family Physicians Association)