H1N1 medical provider handout from the Dept. of Health

Clinical Definition

1. Infection with the H1N1 virus can lead to influenza-like illness (ILI), which is similar to the symptoms of seasonal flu.
2. Influenza-like illness (ILI) is defined as fever with temperature of 100o F or greater, and cough and/or sore throat in the absence of a KNOWN cause other than influenza.
3. Other common symptoms of influenza or H1N1 may include runny or stuffy nose, body aches, headache, chills, fatigue, diarrhea, and vomiting.

Diagnosis

1. Rapid diagnostic testing for influenza A should be done IF the results will affect clinical decision making. Samples should be collected within the first 4 days of illness. Most of the rapid tests that can be done in a physician's office are approximately 50-70% sensitive for detecting influenza and approximately greater than 90% specific. False negative results are more common than false positive results. A positive test is believable, but a negative test may not be accurate.
2. At this time, the Washington State Public Health Laboratories are only testing influenza A lab specimens for subtype H1N1 for hospitalized patients and high priority public health cases.

Treatment

1. Treatment of hospitalized patients and outpatients at high risk for influenza complications should be prioritized. Mild uncomplicated illness should not be treated with antivirals. For those whom antiviral treatment is indicated (see below), treatment should be initiated as soon as possible after the onset of symptoms. The benefits of treatment are strongest when treatment is started within 48 hours of illness onset. Treatment for high-risk patients who are seen more than 48 hours after illness onset and are not improving is permitted.
2. Use of antivirals for treatment of patients at higher risk for influenza-related complications should be considered for:
Children younger than 5 years old. The risk for severe complications from influenza is highest among children younger than 2 years old.
Adults 65 years of age and older.
Persons with the following conditions:
Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
Immunosuppression, including that caused by medications or by HIV/AIDS;
Pregnant women;
Persons younger than 19 years of age who are receiving long-term aspirin therapy; or
Residents of nursing homes and other chronic-care facilities.

Prevention 1. The prevention methods for H1N1 influenza are the same as for seasonal flu:
Cover your cough. Avoid touching your eyes, nose or mouth.
Wash your hands frequently with soap and water or use hand sanitizer.
If you have a fever, stay home for at least 24 hours after the fever has ended without use of fever reducing medications.
Get the seasonal flu and H1N1 vaccines when they become available.
2. When H1N1 vaccine is first available, the Centers for Disease Control and Prevention (CDC) recommends that medical providers vaccinate the following high risk groups first:
Pregnant women;
People who live with or care for children younger than 6 months of age;
Health care and emergency services personnel;
People between the ages of 6 months through 24 years of age; and
People from ages 25 through 64 who have chronic health disorders or compromised immune systems that put them at higher risk for H1N1.