# 3991
The World Health Organization has released revised guidance on the diagnosis and treatment of the H1N1 virus.
It may be downloaded from the WHO site:
Clinical management of human infection with new influenza A (H1N1) virus: revised guidance
Publication date: November 2009
Download the document [pdf 228kb]
This 15 page PDF document covers a wide range of issues. I’ve excerpted a few sections below, but download and read the whole document.
Risk factors for severe disease from pandemic (H1N1) 2009 virus infection reported to date are considered similar to those risk factors identified for complications from seasonal influenza.
- These include the following groups:
• Infants and young children, in particular <2 years
• Pregnant women
• Persons of any age with chronic pulmonary disease (e.g. asthma, COPD)
• Persons of any age with chronic cardiac disease (e.g. congestive cardiac failure)
• Persons with metabolic disorders (e.g. diabetes)
• Persons with chronic renal disease, chronic hepatic disease, certain neurological conditions (including neuromuscular, neurocognitive, and seizure disorders), hemoglobinopathies, or immunosuppression, whether due to primary immunosuppressive conditions, such as HIV infection, or secondary conditions, such as immunosuppressive medication or malignancy
• Children receiving chronic aspirin therapy
• Persons aged 65 years and older
A higher risk of severe complications from pandemic (H1N1) 2009 virus infection has also been reported in individuals who are obese (particularly in those who are morbidly obese) and among disadvantaged and indigenous populations.
On average, about 1/2 of hospitalized patients have had at least one or more underlying medical conditions1
. However, about 1/3 of patients with very severe illness admitted to ICU were previously healthy persons.
Infection control
Evidence to date suggests that pandemic (H1N1) 2009 virus is transmitted similarly to seasonal influenza A and B viruses. Appropriate infection control measures (Standard plus Droplet Precautions) should be adhered to at all times. Whenever performing high-risk aerosol-generating procedures (for example, bronchoscopy or any procedure involving aspiration of the respiratory tract) use a particulate respirator (N95, FFP2 or equivalent), eye protection, gowns, and gloves and carry out the procedure in an adequately ventilated room, either naturally or mechanically, as per WHO guidance 3
The duration of isolation precautions for hospitalized patients with influenza symptoms should be continued for 7 days after onset of illness or 24 hours after the resolution of fever and respiratory symptoms, whichever is longer, while a patient is in a health-care facility. For prolonged illness with complications (i.e. pneumonia), control measures should be used during the duration of acute illness (i.e. until the patient has improved clinically). Special attention is needed in caring for immunosuppressed patients who may shed virus for a longer time period and are also at increased risk for development of antiviral-resistant virus
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