I) Guidelines for use of screening Centre (SC), and Identified Isolation Wards (IIW)

In order to prevent the outbreak of Influenza A (H1N1) virus for Screening, Testing and Isolation following are the guidelines to be followed.

At first all patients will be screened at the screening Centers. The patients attending at health centers will be categorized as follows:

Category C: Patients who do not demonstrate signs and symptoms as described in category B below, but have signs and symptoms of other ailments should be treated symptomatically and send home they will not be administered cap.Tami flu.

Category B : The patients with mild fever, sore throat, running nose, body ache, headache and in few cases, patients with diarrhea and vomiting will be categorized as B and treated symptomatically at screening center itself. They should be administered Oseltamivir treatment and sent for home quarantine. The doctor who has dispensed Oseltamivir should follow up the patient telephonically for monitoring the progress of signs and symptoms and to note side effects, if any.

Category A : In addition to the signs and symptoms demonstrated by category B if the patient has high grade fever, sore throat with severe pharyngitis, breathlessness or signs of other systemic illness like heart diseases lung diseases kidney diseases etc. will be categorized as A. They will be hospitalized in identified isolation wards and throat swabs of all admitted patients will be collected before starting Oseltamivir (Tami flu) treatment.

The task to be undertaken by screening center (SC) and identified isolation wards (IIW) will be as follows:

• Screening center (SC) : All the patients of category B will be treated symptomatically at Screening Centers. Oseltamivir (Tami flu) treatment will be prescribed to the patients with mild fever, cough, sore throat, running nose, body ache, headache. In selected cases of fever, cough with severe pharyngitis, throat swabs will be collected. The Medical Officer/laboratory technicians should be trained for collecting throat swabs. They should adhere to strict infection control protocol.
• Identified Isolation Ward (IIW) : These are the specialized centers identified by public health authorities where the facility for screening as well as hospitalizing the patients for category A and B is available. In these wards all facilities including trained physician, ventilators and other emergency equipment etc. should be available. Throat swab of all the hospitalized patients should be collected immediately on admission irrespective of stage of illness.

Dated 14 th August 2009