With the two labs in the state testing H1N1 overburdened with the load of samples, the Maharashtra government has adopted a new strategy to contain the outbreak by drafting a protocol for doctors to start symptomatic treatment at screening centres itself without waiting for test reports.

One of the major changes in treatment now will be to look out for lower respiratory tract infections as most deaths in the state involved lower respiratory tract problems. So far, doctors were looking at upper respiratory tract infection as one of the symptoms.

Accordingly, if a doctor at an authorised screening centre believes that a patient has symptoms of swine flu, the patient will be categorised as Category A or B or C — for severely infected, moderately infected and mildly infected patients respectively.

“People with severe breathlessness, vomiting, fever for three days, signs of lower respiratory tract infection will be tagged under category A at the screening centre and referred straightaway to the isolation facility,” said Dr Pradeep Awte, chief of Maharashtra’s swine flu cell. Those in category B will be treated for symptoms with a five-day dose of Tamiflu at home. “Category C patients will not be put on Tamiflu, but on paracetamol,” said Dr Awte.

The move follows a government decision to administer Tamiflu to patients who doctors clinically believe to be showing symptoms of H1N1. “Two days back, the Director General of Health Services (DGHS) along with National Center of Communicable Diseases (NCCD) came out with the new protocol. This means that if a doctor feels clinically that a person has symptoms of swine flu he will be administered Tamiflu immediately after taking his or her throat swab, without waiting for test results,” said Dr Awte.

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