Diferencia entre revisiones de «H1N1 (swine) flu»

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==Background==
==Background==
===High-risk groups===
===High-risk groups===
*Pregnant- incr rates of SAB, preterm labor
*Pregnant- increased rates of SAB, preterm labor
*Chronic lung disease
*Chronic lung disease
*Immunosuppressed
*Immunosuppressed
*Cardiac
*Cardiac
*DM
*[[Diabetes mellitus]]


===Screening===
===Screening===
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==Diagnosis==
==Evaluation==
*Rapid Flu nasal swab 60-80% sensitive in detecting influenza A
*Rapid Flu nasal swab 60-80% sensitive in detecting influenza A
**If patient is negative, severely ill and will be hospitalized, send viral culture
**If patient is negative, severely ill and will be hospitalized, send viral culture
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==Management==
==Management==
*Adult: Tamiflu 75-mg capsule twice per day for 5 days
*Adult: [[Tamiflu]] 75-mg capsule twice per day for 5 days
**All hospitalized patients with confirmed, probable or suspected novel influenza (H1N1)
**All hospitalized patients with confirmed, probable or suspected novel influenza (H1N1)
**Patients who are at higher risk for seasonal influenza complications
**Patients who are at higher risk for seasonal influenza complications
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===Post-exposure chemoprophylaxis===
===Post-exposure chemoprophylaxis===
*Tamiflu 75mg PO daily x 10 days (10 days after the last known exposure to novel (H1N1) influenza)
*[[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.''
''If the contact occurred with a patient after 7 days of symptom onset, then chemoprophylaxis is not necessary. This is the presumed post-infectious period.''


==Disposition==
==Disposition==

Revisión actual - 00:11 26 feb 2017

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 symptom onset, then chemoprophylaxis is not necessary. This is the presumed post-infectious period.

Disposition

See Also

References