Management of H1N1 Influenza

H1N1 INFLUENZA A (SWINE FLU)

source http://images.medscape.com/pi/features/misc/swineflu/swine-flu-chart.pdf?src=mp&spon=9&uac=71630FV

Suspected H1N1 Influenza
Patient with:
• Fever > 100.4ºF (> 38ºC) and
• Respiratory signs and symptoms (cough, sore throat, dyspnea) and
• Onset of acute illness within 7 days of close contact with a person who has a confirmed case of influenza A (H1N1) virus infection, or
• Onset of acute illness within 7 days of travel to a community (in the United
States or internationally) where one or more influenza H1N1 cases have been
confirmed, or
• Residence in a community where at least one influenza H1N1 case has been
confirmed.

Laboratory Testing
Obtain and refrigerate a respiratory specimen for H1N1 influenza testing:
o Preferred—nasopharyngeal swab/aspirate or nasal wash/aspirate
o Acceptable—combined nasal swab with oropharyngeal swab
o Intubated patients—also collect an endotracheal aspirate
• Contact state or local health department to facilitate testing at a state public
health laboratory

Infection Control
Institute:
o Standard precautions (hand hygiene)
o Contact precautions (gown & gloves)
o Droplet precautions (eye protection: goggle or full face shield)
o Airborne precautions (N95 or equivalent respirator)
• Use precautions for all patient care activities
• Maintain precautions for 7 days after illness onset or untilsymptoms have resolved.
• Perform suctioning, bronchoscopy,or intubation in a procedure room with negative-pressure air handling
• Instruct patient in respiratory hygiene/cough etiquette

Transport
• Confine patient to AIIR unless transport is essential
• Notify hospital infection control and receiving departments before transporting patient
• Patient must wear surgical mask when outside AIIRr
Transporter should wear N95
• Avoid populated areas during transport; use secure elevator

Disposition in Hospital
• Notify hospital Infection Control
• Place patient in a single-patient room with the door kept closed.
• If available, an airborne-infection isolation room (AIIR) with negative-pressure air handling can

Environmental Control•
Use dedicated noncritical medical equipment (e.g., stethoscope,thermometer) where possible; otherwise, disinfect after use
Follow established guidelines for isolation precautions, including housekeeping practices

Visitors
• Restrict access
• Screen for signs/symptoms of influenza
• Educate in use of infection control

Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007.
http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf
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