Prevention guidelines update released

New Delhi India 13th June 2009: Influenza (commonly called the flu) is a highly contagious viral illness that can occur in children or adults of any age. Influenza usually begins with fever, headache, muscle aches, and fatigue; cough and sore throat may also be present. Symptoms usually improve over two to five days, although the illness may last for a week or more. Weakness and fatigue may continue for several weeks, said Dr KK Aggarwal President Heart Care Foundation of India and Director IMAAKN Sinha Institute.

Frequent handwashing with soap and water can also help limit the spread of influenza. Alcohol-based hand sanitizers can be used when soap and water are not available. Whether you are infected with the flu or are caring for someone with the flu, you should wash your hands frequently.

Because influenza is spread by contact with infected respiratory secretions, people with influenza should avoid face-to-face contact with anyone while sick.  If face-to-face contact is necessary, the infected person should wear a face mask.

Cover the mouth and nose should while coughing or sneezing, and dispose of tissues immediately. Sneezing/coughing into the sleeve of one's clothing (at the inner elbow) is another means of containing sprays of saliva and secretions and has the advantage of not contaminating the hands.

There are numerous options for face masks. N95 respirators are recommended for anyone caring for an infected person. An N95 respirator fits snugly on your face and can filter out small particles that can be inhaled around the edges of other types of face masks. However, it is harder to breathe through an N95 mask for long periods of time compared to a looser fitting mask.

If possible, the infected person should stay in a room separate from common areas of the house, keep the door closed, and use a separate bathroom while ill. The bathroom should be cleaned daily with a disinfectant.

Pregnant women should avoid caring for adults or children infected with the swine H1N1 flu.

In the hospitals patients with suspected or confirmed H1N1 influenza A virus infection should be placed directly into single patient rooms with the door kept closed. Air from the patient's room can be vented directly outside or can be recirculated after high-efficiency particulate (HEPA) filtration.

Standard and contact precautions plus eye protection should be used and continued for seven days after the onset of illness or until symptoms have resolved, whichever is longer.

Health care workers with a febrile respiratory illness should be excluded from work for seven days or until symptoms have resolved, whichever is longer. Asymptomatic health care workers who have had unprotected exposure to H1N1 influenza A may continue to work if they are started on antiviral prophylaxis.

All healthcare workers should wear fit-tested N95 respirators while providing routine care. Clinicians providing care or collecting clinical specimens from suspected or confirmed cases of H1N1 influenza A should wear disposable non-sterile gloves, gowns, and eye protection. Stringent hand hygiene should be adhered to, involving washing hands with soap and water or with an alcohol-based hand sanitizer immediately after removing gloves and other personal protective equipment and after any contact with respiratory secretions.

Personnel involved in aerosol-generating activities (endotracheal intubation, nebulizer treatment, bronchoscopy, cardiopulmonary resuscitation, collection of clinical specimens) should wear a fit-tested N95 respirator. An airborne infection isolation room with negative pressure air handling with 6 to 12 air changes per hour can be used, if available.

The patient should wear a surgical mask if he or she needs to leave the room, should wash hands frequently, and follow respiratory hygiene practices.